Category: Research

Rural Health Research: Utilization of Inpatient and Emergency Services by Rural and Urban Medicaid Enrollees

December 19, 2024

Rural Health Research: Utilization of Inpatient and Emergency Services by Rural and Urban Medicaid Enrollees

This brief used data from the 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) to compare urban and rural residents enrolled in either fee-for-service or managed care Medicaid. Researchers focused on inpatient and emergency department (ED) health care utilization.

Key Findings:

  • Overall utilization by Medicaid enrollees, as measured by number of ED visits, number of inpatient admissions, inpatient length-of-stay, and inpatient readmission rate, is higher in urban areas than in rural areas.
  • Among enrollees who are at least 65 years old, most of whom had Medicare-Medicaid dual eligibility, rural Medicaid enrollees had higher rates of inpatient admissions and ED visits than urban enrollees, while among those in the age categories of below 18 and 18-64 years old, urban enrollees had higher rates. Readmission rates and average inpatient length-of stay were higher in urban enrollees across all age categories.
  • Non-Hispanic Black enrollees had the highest utilization rates compared to enrollees that were non-Hispanic White, and Hispanic of any race. Hispanic enrollees of any race had the lowest utilization rates. Utilization was lowest in Isolated Rural Areas, and often highest in Large Rural areas.
  • Rural female enrollees (except those in Isolated Rural Areas) had higher rates of ED use compared to urban enrollees, while rural male enrollees had lower ED utilization than those in urban areas. Compared to urban areas, male and female enrollees in rural areas had shorter inpatient lengths-of-stay and lower readmission rates.

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Rural Health Research: Variation in Elder Abuse State Statutes by State Level of Rurality

December 19, 2024

Rural Health Research: Variation in Elder Abuse State Statutes by State Level of Rurality

As older adults become a larger proportion of the population, their social and health needs continue to warrant further attention. This is particularly true for older adults in rural areas, where they are a relatively faster growing demographic compared with older adults in urban areas.

One public health concern that needs closer study is older adult maltreatment or elder abuse, and specifically social-contextual factors that lead to geographic differences in preventing and addressing abuse.

This policy brief from the University of Minnesota Rural Health Research Center examines elements of state-level elder abuse statutes’ definitions and reporting requirements to investigate potential differences in these policies by state rurality.

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New Health Workforce Projections Data Available

December 6, 2024

New Health Workforce Projections Data Available

The Health Resources and Services Administration (HRSA) just released the latest projections for the national supply, demand, and distribution of health care workers.

Use the Workforce Projections Dashboard to explore supply and demand trends by occupation, state, year, and more.

Check out Health Workforce projections for an overview of projections for different groups of workers, such as nurses and physicians, and details on our programs that seek to address future shortages.

Click Here to go to Workforce Projections Dashboard

Click Here to see Health Workforce Projections

State of the Primary Care Workforce, 2024

December 6, 2024

State of the Primary Care Workforce, 2024

The Health Resources and Services Administration’s (HRSA’s) National Center for Health Workforce Analysis collects data, conducts research, and generates information to inform and support public and private-sector decision making.

This brief examines the supply of physicians, physician assistants (PA), and nurse practitioners (NP) practicing in primary care specialties:

  • Family medicine
  • General pediatric medicine
  • General internal medicine
  • Geriatric medicine

While rural areas generally have lower primary care physician ratios than urban areas, the data show that NPs and Pas are important in providing primary care in rural areas. Approximately half of PAs were interested in practicing in rural locations (44 percent), Medically Underserved Areas (58%), or Health Professional Shortage Areas (54%).

Click Here to Read State of the Primary Care Workforce, 2024

Peer-Reviewed Publication: Utilization, Quality, and Spending for Pediatric Medicaid Enrollees with Primary Care in Health Centers vs non-Health Centers

December 2, 2024

Peer-Reviewed Publication: Utilization, Quality, and Spending for Pediatric Medicaid Enrollees with Primary Care in Health Centers vs non-Health Centers

Using 2012 Medicaid claims data, HRSA-funded researchers compared cost, use, and quality among health center and non-health center pediatric patients. They found that for health center patients, quality of care was comparable, and total expenditures were lower by $240 per patient. This suggests that delivering primary care pediatric services at a health center may be a more cost-effective health care model.

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Peer-Reviewed Publication: Study Finds that Improving Pediatric Emergency Care Could Save More than 2,100 Children’s Lives Annually

December 2, 2024

Peer-Reviewed Publication: Study Finds that Improving Pediatric Emergency Care Could Save More than 2,100 Children’s Lives Annually

During medical emergencies, children have distinct needs. But 83% of emergency departments nationwide are not highly prepared to meet those needs. The new study, in JAMA Network Open, found that bridging that gap, known as having high levels of “Pediatric Readiness” could prevent the deaths of 2,143 children each year while costing between $0 and $12 per child resident, depending on their state.

The study underscores the importance of MCHB’s partnership in two initiatives, known as the Pediatric Readiness Projects. These projects support the nation’s 5,000+ emergency departments and 15,000+ emergency medical services agencies in improving pediatric emergency care. Data from a recent national emergency department assessment were the foundation for this study.

Click Here to Learn More about Pediatric Readiness Projects

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Rural Health Research – Understanding the Impact of Medical Debt in Rural Communities: Perspectives from Rural Hospital Administrators

November 18, 2024

Rural Health Research – Understanding the Impact of Medical Debt in Rural Communities: Perspectives from Rural Hospital Administrators

This policy brief presents findings from key informant interviews with nine administrators representing rural hospitals in seven states (Arkansas, California, Illinois, Texas, Vermont, Washington, and West Virginia).

Using content analysis of interview data, researchers share findings around hospital and community-level implications of medical debt, and policies that may help or hinder this issue.

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Research and Data Update: Access to Health Care in Rural America: Current Trends and Key Challenges

November 14, 2024

Research and Data Update: Access to Health Care in Rural America: Current Trends and Key Challenges

This research report describes patterns in insurance coverage and uninsurance rates in rural and urban areas, review non-financial challenges in accessing care face by many rural residents, and describes disparities in health outcomes between urban and rural areas.

The report goes on to discuss policies, programs and resources designed to address barriers to care in rural America and the important role that federal and state health car coverage programs like Medicaid, the Children’s Health Insurance Program, Marketplace, and Medicare play in providing health insurance coverage for rural residents.

Click Here to Read Full Report

Rural Health Research: Medical Debt in Collections Among Counties by Rural-Urban Location and Racial-ethnic Composition

November 8, 2024

Rural Health Research: Medical Debt in Collections Among Counties by Rural-Urban Location and Racial-ethnic Composition

Medical debt, or medical costs owed for health care services, is a pressing issue across the U.S., with implications for health and well-being for those facing debt burden. While recognition of medical debt as a social problem is growing, details about who is most at risk of holding this debt remain less clear.

This policy brief addresses this gap by examining the differences in the proportion of people with medical debt in collections and median amount of medical debt by rural-urban communities of color.

Key Findings:

  • Rural counties have a higher proportion of people with medical debt in collections than urban counties (15.7% vs 14.8%), and this difference is associated with lower average household incomes in rural counties in general.
  • The county-level median amount of medical debt in collections held by rural residents is $62 higher compared to their urban counterparts, even after accounting for income differences.
  • The proportion of people with and amount of medical debt in collections are both higher in rural and urban communities of color than in rural and urban communities overall.

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HHS: Current Trends and Key Challenges to Health Care in Rural America

November 8, 2024

HHS: Current Trends and Key Challenges to Health Care in Rural America

A new report evaluates programs at the U.S. Department of Health & Human Services (HHS) and finds that uninsured rates among adults under age 65 in rural areas have fallen substantially since the passage of the Affordable Care Act (ACA), from 23.8 percent in 2010 to 12.6 percent in 2023.

Uninsured rates among rural residents are much higher is states that have not yet expanded Medicaid and analysts acknowledge ongoing disparities in health outcomes between rural and urban areas.

Research has shown, for instance, disparities in maternal outcomes, behavioral and mental health outcomes, risk factors for chronic disease such as obesity, hypertension, and cardiovascular disease as well as in potentially harmful health behaviors such as smoking and physical inactivity to name a few.

Click Here to read full report