Rural Health
Resources by State: North Carolina
Recent Incarceration, Substance Use, Overdose, and Service Use Among People Who Use Drugs in Rural Communities
Compares 2,935 people who use drugs (PWUD) in rural areas of 10 states to evaluate the impact of time since last incarceration on access to treatment and overdose rates. Discusses policy measures that could increase access to and successful completion of treatment for substance use disorders.
Author(s): Daniel B. Hoover, Todd Korthuis, Elizabeth Needham Waddell, et al.
Citation: JAMA Network Open, 6(11), 2342222
Date: 11/2023
Type: Document
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Compares 2,935 people who use drugs (PWUD) in rural areas of 10 states to evaluate the impact of time since last incarceration on access to treatment and overdose rates. Discusses policy measures that could increase access to and successful completion of treatment for substance use disorders.
Author(s): Daniel B. Hoover, Todd Korthuis, Elizabeth Needham Waddell, et al.
Citation: JAMA Network Open, 6(11), 2342222
Date: 11/2023
Type: Document
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A Place to Thrive: Creating Opportunities to Age Well in North Carolina
Reports on North Carolina's aging population, and provides recommendations and strategies for improved health and livability for an aging population. Key topics include social and economic factors affecting older adults, the culture of aging, services and programs that support aging in place, and workforce supporting older adults' needs. Mentions rural population throughout as a disproportionately affected group.
Date: 10/2023
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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Reports on North Carolina's aging population, and provides recommendations and strategies for improved health and livability for an aging population. Key topics include social and economic factors affecting older adults, the culture of aging, services and programs that support aging in place, and workforce supporting older adults' needs. Mentions rural population throughout as a disproportionately affected group.
Date: 10/2023
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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North Carolina State Health Improvement Plan 2023
Describes North Carolina's 2023 plan for population health improvement. Provides data on selected health indicators, makes comparisons to 2030 targets, and identifies trends over time for selected demographics. Identifies factors contributing to health disparities and negative health outcomes, and sets priorities. Includes consideration of rural and underserved populations throughout.
Date: 10/2023
Type: Document
Sponsoring organization: North Carolina Department of Health and Human Services
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Describes North Carolina's 2023 plan for population health improvement. Provides data on selected health indicators, makes comparisons to 2030 targets, and identifies trends over time for selected demographics. Identifies factors contributing to health disparities and negative health outcomes, and sets priorities. Includes consideration of rural and underserved populations throughout.
Date: 10/2023
Type: Document
Sponsoring organization: North Carolina Department of Health and Human Services
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Self-Collection for Primary HPV Testing: Perspectives on Implementation From Federally Qualified Health Centers
Analyzes feedback from clinical staff, administrative staff, and leadership in Federally Qualified Health Centers (FQHCs) regarding the implementation of primary testing for high-risk human papillomavirus (HPV) by self-collection. Utilizes focus group and interview data from 6 North Carolina FQHCs about themes such as increased screening rates, accuracy of self-collection results, workflow disruptions, financial implications, impacts on clinic quality measures, and more. Includes feedback from rural FQHCs.
Author(s): Amanda Le, Catherine Rohweder, Stephanie B. Wheeler, et al.
Citation: Preventing Chronic Disease, 20
Date: 10/2023
Type: Document
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Analyzes feedback from clinical staff, administrative staff, and leadership in Federally Qualified Health Centers (FQHCs) regarding the implementation of primary testing for high-risk human papillomavirus (HPV) by self-collection. Utilizes focus group and interview data from 6 North Carolina FQHCs about themes such as increased screening rates, accuracy of self-collection results, workflow disruptions, financial implications, impacts on clinic quality measures, and more. Includes feedback from rural FQHCs.
Author(s): Amanda Le, Catherine Rohweder, Stephanie B. Wheeler, et al.
Citation: Preventing Chronic Disease, 20
Date: 10/2023
Type: Document
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Telehealth Use and Access to Neurology Outpatient Clinical Services for Children: An Observational Cohort Study
Analyzes pediatric neurology appointment completion, cancellation, and no-show rates among telehealth users and telehealth non-users at a tertiary care children's hospital in North Carolina. Compares appointment outcomes before and during the first year of the COVID-19 pandemic, including rural versus urban demographic and outcome data.
Author(s): Savithri Nageswaran, Annette Grefe, Shyh-Huei Chen, Eric Kirkendall, Edward H. Ip
Citation: North Carolina Medical Journal, 85(1)
Date: 09/2023
Type: Document
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Analyzes pediatric neurology appointment completion, cancellation, and no-show rates among telehealth users and telehealth non-users at a tertiary care children's hospital in North Carolina. Compares appointment outcomes before and during the first year of the COVID-19 pandemic, including rural versus urban demographic and outcome data.
Author(s): Savithri Nageswaran, Annette Grefe, Shyh-Huei Chen, Eric Kirkendall, Edward H. Ip
Citation: North Carolina Medical Journal, 85(1)
Date: 09/2023
Type: Document
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Assessing the Impact of Medicaid Telehealth Policy Change on Equitable Access to Telehealth Services in North Carolina
Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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"This Is Not My Grandmother's Summer": Rural Populations Are Uniquely Vulnerable to the Health Impacts of Extreme Heat
Discusses the challenges rural areas face in helping address the impact of heat on health. Includes strategies used in rural North Carolina, Indiana, and Washington State to help inform and protect rural residents, including those exposed to heat through work outdoors.
Author(s): Brendan Stermer
Citation: Rural Monitor
Date: 09/2023
Type: Document
Sponsoring organization: Rural Health Information Hub
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Discusses the challenges rural areas face in helping address the impact of heat on health. Includes strategies used in rural North Carolina, Indiana, and Washington State to help inform and protect rural residents, including those exposed to heat through work outdoors.
Author(s): Brendan Stermer
Citation: Rural Monitor
Date: 09/2023
Type: Document
Sponsoring organization: Rural Health Information Hub
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Addressing Social Needs through Medicaid: Lessons from Planning and Early Implementation of North Carolina's Healthy Opportunities Pilots
Results of a study to generate findings and recommendations from the planning, capacity-building, and early implementation of the Healthy Opportunities Pilots program. Focuses on the health-related social needs of North Carolina Medicaid enrollees living in three primarily rural regions of the state.
Author(s): Katie M. Huber, William K. Bleser, Rebecca G. Whiteaker, et al.
Date: 09/2023
Type: Document
Sponsoring organizations: Duke-Margolis Center for Health Policy, Milbank Memorial Fund
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Results of a study to generate findings and recommendations from the planning, capacity-building, and early implementation of the Healthy Opportunities Pilots program. Focuses on the health-related social needs of North Carolina Medicaid enrollees living in three primarily rural regions of the state.
Author(s): Katie M. Huber, William K. Bleser, Rebecca G. Whiteaker, et al.
Date: 09/2023
Type: Document
Sponsoring organizations: Duke-Margolis Center for Health Policy, Milbank Memorial Fund
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Final Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on access to care, health equity, and Medicare spending. Explores whether the model had unique impacts on access to home health care in rural areas.
Additional links: Appendices, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Arbor Research Collaborative for Health, Centers for Medicare and Medicaid Services, L&M Policy Research
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Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on access to care, health equity, and Medicare spending. Explores whether the model had unique impacts on access to home health care in rural areas.
Additional links: Appendices, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Arbor Research Collaborative for Health, Centers for Medicare and Medicaid Services, L&M Policy Research
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A Road Map for Asset Based Investing in Central Appalachia
Report highlighting various wellbeing and community asset measures in the Appalachian region in the areas of economics, population health, infrastructure, housing, health facilities, and more. Discusses the associations between wellbeing and community assets as well as the implications for investment.
Date: 08/2023
Type: Document
Sponsoring organizations: Community and Economic Development Initiative of Kentucky, Reinvestment Fund
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Report highlighting various wellbeing and community asset measures in the Appalachian region in the areas of economics, population health, infrastructure, housing, health facilities, and more. Discusses the associations between wellbeing and community assets as well as the implications for investment.
Date: 08/2023
Type: Document
Sponsoring organizations: Community and Economic Development Initiative of Kentucky, Reinvestment Fund
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