Category: Rural Health Research Gateway

Webinar: HIV and Hepatitis C in Rural Areas: Prevalence, Service Availability, and Challenges

Date: Wednesday, April 21, 2021
Time: 10:00 AM Pacific, 11:00 AM Mountain, 12:00 PM Central, 1:00 PM Eastern
Website: ruralhealthresearch.org/webinars/hiv-and-hepatitis-c
Zoom Link: https://und.zoom.us/j/97215444909

Speakers will highlight findings from recent work on estimating HIV prevalence and maternal hepatitis C prevalence in rural areas across the U.S. Speakers will also discuss findings from a qualitative study on the challenges and promising practices in addressing HIV and hepatitis C outbreaks in rural areas. Presenters for this webinar include Katherine Ahrens and Amanda Burgess from the Maine Rural Health Research Center.

Post-acute Care Trajectories for Rural Medicare Beneficiaries: Planned versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies

Post-acute care services are designed to help patients transition from hospitalization in acute care facilities to their homes. Skilled nursing facilities and home health agencies provide the majority of post-acute care services to Medicare beneficiaries. This study used Medicare administrative data for rural, fee-for-service Medicare beneficiaries to describe post-acute care trajectories following acute hospitalization and examine differences between planned discharge disposition from the hospital and actual post-acute care received.

The majority (56.3%) of rural beneficiaries did not receive post-acute care following hospital discharge, while about a quarter (26.1%) experienced at least one care transition. Transition to skilled nursing facility (23.7%), transition to home health agency (18.2%), and transition to a skilled nursing facility followed by an additional transition to a home health agency (6.9%) were the most common trajectories among rural beneficiaries who received post-acute care. Gaps exist between planned and actual receipt of post-acute care as 88.9% of rural beneficiaries who had a planned discharged to a skilled nursing facility received this care and 58.7% of rural beneficiaries who had a planned discharge to a home health agency received this care. Identification of the reasons for the gaps between planned versus actual discharge to post-acute care and the outcomes for those who did not receive planned care will be critical for determining appropriate supports to improve care transitions for rural beneficiaries.

The full study is available here.

Contact Information:

Tracy Mroz, PhD
WWAMI Rural Health Research Center
Phone: 206.598.5396
tmroz@uw.edu

Geographic Expansion of Medicaid Managed Care Organizations

As states have increasingly contracted with managed care organizations (MCOs) to serve their Medicaid populations, many of the counties newly served by Medicaid MCOs within the last decade have been nonmetropolitan counties. This brief assesses access to primary care in nonmetropolitan counties for Medicaid recipients in 15 states that expanded Medicaid MCOs to new geographic areas across the state from 2012-2018.

Researchers calculated and analyzed a “primary care provider (PCP) access score” (summarizing actual driving times to the nearest primary care) using geospatial methods and assessed the relationship between stronger state policies on network adequacy to observed PCP access scores in nonmetropolitan settings. The study found that nonmetropolitan counties that had Medicaid MCOs prior to 2012 experienced better access to primary care than nonmetropolitan counties that expanded to Medicaid MCO coverage after 2012, and that nonmetropolitan counties in states that specify stronger network adequacy travel time requirements for PCPs had better PCP access scores on average than those in states that allow longer travel times. Additionally, researchers estimate that among nonmetropolitan counties that were newly served by Medicaid MCOs in 2012-2018, a segment of roughly 45,000 Medicaid recipients experienced relatively low PCP access scores and thus less access to primary care.

Contact Information:

Timothy D. McBride, MS, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 314.935.4356
tmcbride@wustl.edu

Additional Resources of Interest:

New Articles Published on Inpatient Volume, Long-Term Care Planning, Emergency Department Telemedicine, Cancer, and Hepatitis C

These journal articles written by the Rural Health Research Centers were recently added to Gateway.

Gateway lists the journal, a brief summary, and a link to additional information and access to the full text of the article, if available. While some journal articles are freely available, many require a subscription or affiliation with a subscribing library.