Rural versus urban health centers: A comparison of financial performance

In a previous paper[1], data were analyzed from the 1998-2004 Uniform Data System (UDS) to identify trends and predictors of financial performance for health centers. Several differences were noted regarding revenues, self-sufficiency, service offerings, and urban/rural settings. For this presentation, the UDS data were analyzed to identify trends and predictors of financial performance for rural versus urban health centers. Urban centers saw an increase in service revenues from 52% in 1998 to 60% in 2004 (15.4% change), and corresponding decrease in grant revenues, while rural center revenue service remained approximately the same at 62-63% of total revenue. Collections from all sources increased for both urban and rural centers; however, rural centers saw a greater percent change increase in collections during the study period, ranging from 29.5% change to 60.3% change from 2004 to 1998). Total encounter costs increased for both settings in each year (35.4% change for urban centers; 54.0% change for rural centers), and costs for rural centers approached those of urban centers (average office visit of $135.42 for urban centers and $130.43 for rural centers). Self-sufficiency, the ratio of service payments to total costs, increased for centers in both settings, but was less dramatic for rural centers (9.2% change versus 32.3% change). In addition to increased costs, self-sufficiency was further hampered by declines in provider productivity. Rural centers were more likely to experience steady declines in physician productivity over time (13.8% change). Factors involved in these comparisons are discussed with a goal of discerning best practices.

[1]Martin, B., Shi, L., & Ward, R. (in press). Financial performance and managed care trends of health centers, The Journal of Health are Finance.