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Rural Health
Resources by Topic: Healthcare business and finance

How Has the ACA Changed Finances for Different Types of Hospitals? Updated Insights from 2015 Cost Report Data
Compares the impact of whether states decided to expand Medicaid on hospital finances, including an exploration of the impact on various types of hospitals. Examines and compares hospital financial indicators such as uncompensated care, Medicaid revenue, operating margin, and excess margins from fiscal year (FY) 2011 through FY 2015. Includes an extensive discussion on the variation between metro and nonmetro hospitals, and provides tables and charts to help illustrate trends.
Author(s): Fredric Blavin
Date: 04/2017
Type: Document
Sponsoring organizations: Robert Wood Johnson Foundation, Urban Institute
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Monroe County Hospital Achieving Outcomes
Examines the gains made by Monroe County Hospital, located in Monroeville, Alabama, as part of the Small Rural Hospital Transition project. During the project, the 35-bed prospective payment system (PPS) hospital focused on improving patient education and transitions of care, integrating pharmacists, implementing bedside reporting, and reducing readmission rates. The changes have resulted in improved community engagement and prepared MCH for value-based purchasing.
Date: 04/2017
Type: Document
Sponsoring organization: National Rural Health Resource 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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Report to Congress on Medicaid and CHIP, March 2017
Reports on three aspects of Medicaid: Disproportionate Share Hospital (DSH) payments to states and providers, access to Medicaid, and children's coverage under CHIP. Chapter 2 includes the second annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 2-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals. Chapter 3 examines state policies for distributing DSH payments to hospitals, including which states target rural or Critical Access Hospitals.
Date: 03/2017
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Promising Practice: GA SORH Looks at the Feasibility of EMS Regionalization in the State
Reports on a study undertaken by the Georgia State Office of Rural Health (GA-SORH) and the Association County Commissioners of Georgia (ACCG) to determine if regionalization of emergency medical services (EMS) among counties was feasible as a way to fill the gaps left from the closure of several rural hospitals in the state.
Author(s): Beth Blevins
Date: 03/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Behavioral Health Treatment Needs and Outcomes for Washington Counties
Provides county-level behavioral health data for Medicaid enrollees in Washington. Includes data breakdowns for those covered under Medicaid expansion, adults with disabilities, and by race/ethnicity and age group. Covers mental health, substance abuse, co-occurring disorders, criminal justice involvement, emergency department use, homelessness, and more.
Date: 03/2017
Type: Website
Sponsoring organization: Washington State Department of Social and Health Services
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Medicaid Expansion, Budgetary Projections, and Impact on Hospitals
Examines the impact of Medicaid expansion in Louisiana on rural hospitals, healthcare providers, and the state budget. Addresses the potential impact on rural hospitals of a cutback in disproportionate share (DSH) payments for uncompensated care.
Author(s): James A. Richardson, Jared J. Llorens, Roy L. Heidelberg
Date: 03/2017
Type: Document
Sponsoring organization: Louisiana Public Health Institute
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Medicaid Expansion in Louisiana: Perspectives of Providers from Federally Qualified Health Centers and Rural Health Centers
Reports on interviews with Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Louisiana to analyze the impact of Medicaid expansion. Describes the impact on health care access, changes made by FQHCs and RHCs, and the need for more healthcare providers.
Date: 03/2017
Type: Document
Sponsoring organization: Louisiana Public Health Institute
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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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Health Insurance Coverage, Health Care Utilization, and Health Outcomes within the Context of Marcellus Shale Development
A discussion of the public health impacts of the Marcellus Shale natural gas well development in four Pennsylvania counties. Includes comparisons of health insurance coverage rates and availability; the burden of increased utilization of healthcare facilities and services; and health outcomes as they relate to the environmental effects of natural gas extraction.
Date: 03/2017
Type: Document
Sponsoring organization: Center for Rural Pennsylvania
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