Cutler Institute for Health and Social Policy

Population Health and Health Policy

Rural Inpatient Psychiatric Units Improve Access to Community-Based Mental Health Services, but Medicare Payment Policy a Barrier

Abstract: 

<li>Of approximately 1500 small rural hospitals (less than 50 beds), 80 or about
five percent have an inpatient psychiatric unit. <li>Ninety-five percent of rural hospitals with IPUs have outpatient mental health services available locally compared with 57% in a previous survey of rural hospitals. <li>Mental health practitioners who staff rural IPUs often provide outpatient services in the local community, splitting their time between
staffing the hospital unit and their community practice. <li>Prospective payment for inpatient psychiatric facilities is cited as a major factor in recent closures of several rural IPUs.

Publication Type: 
Report
Publish Date: 
December 26, 2007
URL: 
http://muskie.usm.maine.edu/Publications/rural/pb36/IPU.pdf

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Dr. Ziller to speak on Rural Implementation and Impact of Medicaid Expansions

The impact of the ACA Medicaid expansion on health care coverage and access in rural areas is largely unknown and will depend on the different state policy contexts in which the expansions are implemented and on existing system capacity. Understanding how many rural residents are likely to become newly eligible for Medicaid under the ACA, as well as their characteristics and health status, will provide important information to aid policymakers in structuring outreach and enrollment strategies and ensuring that the healthcare infrastructure and delivery systems in rural areas can address the needs of these individuals.

On March 18th, Dr. Ziller, Deputy Director of the Maine Rural Health Research Center at the University of Southern Maine, will present via a SHARE webinar, nationally representative information identifying rural-urban differences among low-income non-elderly adults (18 to 65) in the following areas:

  • Medicaid eligibility, pre-ACA
  • Medicaid participation, pre-ACA
  • New Medicaid eligibility in 2014

Dr. Ziller will also analyze the characteristics associated with any rural-urban differences in the above areas. Characteristics to be considered include age, gender, employment, education, income, Census region, health status, current relationship to primary care provider, primary care supply, and FQHC availability.

This webinar is based on Dr. Ziller's research under a State Health Access Reform Evaluation (SHARE) grant to inform federal and state implementation of the ACA Medicaid expansion by estimating the size and characteristics of the rural population likely to be newly eligible.
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