Our research team has identified topical areas warranting further investigation to inform federal and state health policy makers, health insurers, health system managers, and providers about how to more effectively organize, finance, and deliver care in highly impoverished/underserved and other rural areas across America.
Changes in Access to Care During the Public Health Emergency: Examining Rural-Urban Disparities by Insurance Type
Project Link: Rural Health Research GatewayUsing the Behavioral Risk Factor Surveillance System data, this study will compare key access to care indicators among adult beneficiaries residing in rural and urban areas before and after the Public Health Emergency by types of health insurance. We will explore state-level policy variations, such as the Affordable Care Act (ACA) Medicaid expansion and COVID-19-related Medicaid coverage for uninsured adults.
Principal Investigator
Ahmed A. Arif, PhD, CPH, FACE, Associate Professor of Public Health Sciences at UNCC
Evaluating the Impact of Inflation Reduction Act Provisions on Medicare Advantage Prescription Drug Costs
Project Link: Rural Health Research GatewayUsing Merative MarketScan data, this study will evaluate changes in the affordability of prescription drugs for urban and rural Medicare beneficiaries before and after the recent Inflation Reduction Act (IRA). The primary outcome will be an assessment of whether the IRA succeeded in reducing costs and identifying any remaining health disparities.
Principal Investigator
Jeffery Talbert, PhD, Professor in the Department of Pharmacy Practice and Science, and Director of the Institute for Pharmaceutical Outcomes and Policy in the UK College of Pharmacy
Impact of High Deductible Health Plans on Rural Populations
Project Link: Rural Health Research GatewayUsing data from Merative MarketScan insurance claims, this study will investigate utilization, spending, and care patterns of rural members enrolled in high deductible health plans (HDHP) compared to traditional plans. Trends in health outcomes before and after HDHP growth will be assessed to inform policy design tailored to rural residents.
Principal Investigator
Jeffery Talbert, PhD, Professor in the Department of Pharmacy Practice and Science, and Director of the Institute for Pharmaceutical Outcomes and Policy in the UK College of Pharmacy
Rural/Urban Variations in Drug and Alcohol Use Treatment
Project Link: Rural Health Research GatewayUsing the National Survey on Drug Use and Health, this study will investigate rural vs. urban variations in treatment utilization for alcohol use disorder (AUD) and, separately, drug use disorder (DUD). It will yield prevalence estimates of any treatment receipt and sources of treatment among persons with past year AUD and DUD as well as the receipt of medication therapy among those treatable with medications.
Principal Investigator
Tyrone F. Borders, PhD, Professor, College of Nursing
Work Settings, Education, and Intent to Leave Practice among Rural vs. Urban Nurses
Project Link: Rural Health Research GatewayUsing data from the 2022 National Nursing Workforce Survey, this project will describe rural/urban differences in nurses’ work settings, levels of education and licensure, demographic characteristics, income, and intention to retire or leave practice. Study findings could be applied to implement policies aimed at increasing nursing school output and attracting nurses to practice in rural areas.
Principal Investigator
Tyrone F. Borders, PhD, Professor, College of Nursing
Risky Substance Use among Rural and Urban Adults: An Update
Project Link: Rural Health Research GatewayVery little research has examined rural vs. urban differences in substance misuse and treatment access nationally. Using public and nationally representative data from the NSDUH, this project will 1) Estimate and compare alcohol use and binge drinking and 2) Estimate and compare drug use (marijuana, other illicit drugs, and non-medical use of other drugs) between non-metropolitan and metropolitan adults.
Principal Investigator
Tyrone F. Borders, PhD, Professor, College of Nursing
Disparities in Screening, Prevention, and Management of Cardiovascular Disease in Rural and Urban Primary Care
Project Link: Rural Health Research GatewayPresentations:
This study will use a large national primary care registry to compare cardiovascular disease (CVD) screening, prevention, and management quality measures between rural and urban primary care practices. It will also assess for disparities by patient composition of the practice.
Principal Investigator
Lars E. Peterson, MD, PhD, Vice President at American Board of Family Medicine
Third Party Negotiated Pricing in Rural and Urban Hospitals
Project Link: Rural Health Research GatewayPresentations:
We will use third party negotiated pricing information to compare prices in urban and rural hospitals, across a variety of common services. Because there has been poor compliance with the Centers for Medicare & Medicaid Services (CMS) requirement to publish third party negotiated pricing, we will also examine if the availability of this information differs for rural and urban hospitals.
Principal Investigator
Lindsey Hammerslag, PhD
Co-Investigator
Jeffery Talbert, PhD, Professor in the Department of Pharmacy Practice and Science, and Director of the Institute for Pharmaceutical Outcomes and Policy in the UK College of Pharmacy
Availability and Characteristics of Outpatient and Residential Substance Use Treatment in Rural and Urban Areas
Project Link: Rural Health Research GatewayThis study will look at: 1) the availability of residential and outpatient treatment centers in rural and urban counties, including identifying counties with no facilities; and 2) characteristics of services offered (e.g., residential, outpatient), demographics of persons treated, and insurance plans accepted by rural vs urban centers.
Principal Investigator
Tyrone F. Borders, PhD, Professor, College of Nursing
Co-Investigator
Jeffery Talbert, PhD, Professor in the Department of Pharmacy Practice and Science, and Director of the Institute for Pharmaceutical Outcomes and Policy in the UK College of Pharmacy
Project Data Scientist-Statistician
Aaron P. Smith, PhD
Mental Health Treatment among Rural and Urban Adults at Risk for Suicide
Project Link: Rural Health Research GatewayThis study will look at rural/urban disparities in 1) the receipt and sources of mental health treatment among adults with suicidal thoughts and attempts using data from the National Survey on Drug Use and Health (NSDUH); and 2) mental health follow-up visits among adults with a hospital admission or emergency department visit for self-inflicted harm using data from a national insurance claims dataset.
Principal Investigator
Tyrone F. Borders, PhD, Professor, College of Nursing
Co-Investigator
Jeffery Talbert, PhD, Professor in the Department of Pharmacy Practice and Science, and Director of the Institute for Pharmaceutical Outcomes and Policy in the UK College of Pharmacy
Project Data Scientist-Statistician
Aaron P. Smith, PhD