Category: Research

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

New FMT Policy Brief: CAH Perspectives on Collection and Use of Demographic and Social Drivers of Health Data

October 29, 2024

New FMT Policy Brief: CAH Perspectives on Collection and Use of Demographic and Social Drivers of Health Data

The Flex Monitoring Team (FMT) recently released a new policy brief, CAH Perspectives on Collection and Use of Demographic and Social Drivers of Health Data. The brief explores the experiences of nine Critical Access Hospitals (CAHs), in collecting and using demographic and/or social drivers of health (SDOH) data.

Challenges faced by CAHs during data collection:

  • Interviewee discomfort
  • Difficulty offering patient resources
  • Logistical or technical challenges
  • Limited staff capacity
  • Other broad challenges

Despite these challenges, CAHs described being able to use the demographic and/or SDOH data in various ways:

  • For individual patient needs
  • To assess community characteristics and needs
  • To assess health outcomes and utilization
  • To create or leverage partnerships
  • To plan for expanding data collection

Staff training, involvement with community partnerships, and collaboration with State Flex Programs will facilitate the best and standard practices of demographic and/or SDOH data collection, as well as data usage for CAHs.

Click Here to view policy brief

An Updated Model of rural Hospital Financial Distress – North Carolina Rural Health Research and Policy Analysis Center

October 10, 2024

An Updated Model of rural Hospital Financial Distress – North Carolina Rural Health Research and Policy Analysis Center

From January 2005 to May 2024, 219 rural hospitals closed or converted to a facility without inpatient services. Hospital financial distress is often cited as a main contributor to closure and thus is a key target for policies aimed to protect rural health care access.

Researchers from the North Carolina Rural Health Research and Policy Analysis Center created a model for predicting rural hospital closures in 2017. This update for 2024 was published last week in the Journal of Rural Health.

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New FMT Brief: Characteristics of Communities Affected by Critical Access Hospital Mergers

September 30, 2024

New FMT Brief: Characteristics of Communities Affected by Critical Access Hospital Mergers

The Flex Monitoring Team (FMT) has released a new policy brief, Characteristics Affected by Critical Access Hospital Mergers.

This brief provides comparative statistics on the demographic, socioeconomic, health status, and geographic characteristics of communities served by Critical Access Hospitals (CAHs) by their merger status.

Findings from this study will help inform hospital leaders, State Flex Programs, and policymakers about community characteristics that may be associated with CAH mergers, and about the rural populations that are affected by CAH mergers.

Key findings from this brief include:

  • Between 2010 and 2022, CAHs were the targets of 128 mergers, meaning a health care entity acquired or merged them under a single owner.
  • CAH mergers were unevenly distributed across the U.S. Census regions, largely concentrated in the Midwest and the South.
  • Communities where CAHs merged had:
    • Lower rates of insurance for both adults and children
    • Lower median income inequality
    • Higher unemployment rates compared with counties without CAH mergers

Click Here to View Policy Brief

Rural Health Research Gateway – The Low-Volume Hospital Adjustment Before and During COVID-19

August 9, 2024

Rural Health Research Gateway – The Low-Volume Hospital Adjustment Before and During COVID-19

This brief from the North Carolina Rural Health Research and Policy Analysis Center provides an update to a 2016 analysis of the profitability of low-volume rural Prospective Payment System hospitals under the Affordable Care Act’s qualifying criteria.

The Low-Volume Hospital (LVH) adjustment is for hospitals with fewer than 3,800 patient discharges in the previous year that are more than 15 miles from the nearest Inpatient Prospective Payment System acute care hospital.

Qualifying hospitals receive a payment adjustment up to an additional 25% for every Medicare patient discharge.

Click Here to Read the Brief

Hospital Services Research Brief

July 25, 2024

Hospital Services Research Brief

Social Determinants of Health (SDOH) and screening patients for Health-Related Social Needs (HRSN) is conducted by most hospitals and medical centers in the United States.

The article published by Health Services Research states that many hospitals do have programs or strategies to address HRSN and/or SDOH, but it remains unclear how these relate to use of data captured through the screening process.

Collection of social needs data may help inform the development of programs to strategies to address HRSN and SDOH. This, in turn, can enable providers to screen for these needs and use the data in the near term for care delivery and in the long term to address community and population needs.

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Rural Health Research on Rural Hospital Profitability from 2018 to 2023

June 27, 2024

Rural Health Research on Rural Hospital Profitability from 2018 to 2023

Profitability of rural hospitals in 2020-21 and 2021-22 was influenced by the Public Health Emergency (PHE) funding distributed during the COVID-19 pandemic.

Three briefs from the North Carolina Rural Health Research and Policy Analysis center examine hospital profitability from 2018 to 2023, taking PHE funding into account.

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Rural Health Research: Understanding the Rise of Ransomware Attacks on Rural Hospitals

June 24, 2024

Rural Health Research: Understanding the Rise of Ransomware Attacks on Rural Hospitals

Among the key findings in this brief from the University of Minnesota Rural Health Research Center:

  • Rural hospitals experienced an increasing number of ransomware attacks from 2016 to 2021.
  • From 2016 to 2021, 43 rural hospitals across 22 states experienced a ransomware attack.
  • Ransomware attacks afflicted all types of rural hospitals, including:
  • Critical Access Hospitals (N=9)
  • Sole Community Hospitals (N=13)
  • Rural Referral Centers (N=3)
  • Hospitals paid under Medicare’s Inpatient Prospective Payment System (N=18).

Eighty-four percent of ransomware attacks on rural hospitals resulted in operational disruptions. Common disruptions included electronic system downtime (81%), delays or cancellations in scheduled care (42%), and ambulance diversion (33%). Operational disruptions were similar in rural and urban hospital settings.

Click Here to Read Research Alert