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Rural Health
Resources by Topic: Closures of healthcare facilities and services

Rural Hospital Stabilization Committee Pilot Program Report
Reports on the initial results of using a "hub and spoke" model in Georgia to help address rural hospital financial pressures and emergency department overuse. Highlights the progress made by the initial four hub hospitals and the spokes, which included school-based healthcare and Federally Qualified Health Centers. Additional link provides performance metrics for the pilot.
Additional links: Profile for Rural Hospital Stabilization Committee (Data from SFY 2016 Phase 1 Pilot Program)
Date: 11/2017
Type: Document
Sponsoring organization: Georgia State Office of Rural Health
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ESRD Facility Characteristics by Rurality and Risk of Closure
Profiles rural end-stage renal disease (ESRD) facilities, especially the ones at greatest risk for closure. Examines the facilities' characteristics, quality of care, and distance their patients would need to travel if the facilities should close. Features statistics with breakdowns by urban and rural locations.
Author(s): Jan M. Eberth, Fozia Ajmal, Kevin Bennett, Janice C. Probst
Date: 11/2017
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Ensuring Access with a Hospital's Conversion to a Freestanding Emergency Department
Outlines Ellijay, Georgia-based North Georgia Medical Center's transition from a traditional community hospital to a freestanding emergency department (ED). Shares administrative, legal, and logistical challenges that, once overcome, resulted in Piedmont Mountainside Hospital Emergency Services - a successful, community-focused, freestanding ED.
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Access To Obstetric Services In Rural Counties Still Declining, With 9 Percent Losing Services, 2004-14
Results of a study identifying gaps in the availability of hospital-based obstetric services in rural America, and providing evidence of disparities in local access to obstetric services in vulnerable rural communities. Includes statistics on percentages of rural counties by status of hospital obstetric services from 2004–14, with breakdowns by micropolitan or noncore location, and a county-level map with shadings indicating full closure, continuous services, or no services.
Author(s): Peiyin Hung, Carrie E. Henning-Smith, Michelle M. Casey, Katy B. Kozhimannil
Citation: Health Affairs, 36(9), 1663-1671
Date: 09/2017
Type: Document
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Rethinking Rural Hospitals
Discusses the various factors associated with rural hospital closures, and makes the case for adopting new, innovative approaches to rural healthcare delivery.
Author(s): Diana J. Mason
Citation: JAMA: Journal of the American Medical Association, 318(2), 114-115
Date: 07/2017
Type: Document
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After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care
Describes ways for rural communities to develop optimal healthcare delivery systems after a local hospital closure. Features 3 case studies from Arizona, Michigan, and Illinois. Includes tables showing options currently available under federal and state laws and policies under consideration.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 06/2017
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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State Variability in Access to Hospital-Based Obstetric Services in Rural U.S. Counties
Policy brief examining differences in availability of obstetric services in rural counties of all states, 2004-2014. Features statistics with breakdowns by all rural counties, micropolitan, and noncore areas.
Author(s): Peiyin Hung, Katy Kozhimannil, Michelle Casey, Carrie Henning-Smith
Date: 04/2017
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Rural Counties
Policy brief describing a study examining obstetric unit and hospital closures in rural areas of the United States, 2004-2014. Features statistics with breakdowns by all rural counties, micropolitan, and noncore areas.
Author(s): Peiyin Hung, Katy Kozhimannil, Carrie Henning-Smith, Michelle Casey
Date: 04/2017
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Issues Confronting Rural Pharmacies after a Decade of Medicare Part D
Discusses the major challenges facing rural independent pharmacies, focusing on delayed maximum allowable cost (MAC) adjustments, and direct and indirect remuneration (DIR) fees. Other challenges include competition from mail order pharmacies, being a non-preferred pharmacy, and orderly succession planning. Also examines the implications for rural communities when independent pharmacies close.
Author(s): Abiodun Salako, Fred Ullrich, Keith Mueller
Date: 04/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural Hospital Environmental Impact Study
Examines the rapidly changing healthcare landscape, particularly as it relates to rural Texas, by focusing on four areas: the state of healthcare, rural hospital closures and vulnerabilities, the impact of the Affordable Care Act, and uninsurance rates. Presents information about the current and future state of healthcare in rural Texas to support rural health policymakers.
Date: 03/2017
Type: Document
Sponsoring organization: Texas Organization of Rural & Community Hospitals
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