Rural Health
Resources by Topic: Health insurance
MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 9
Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2018-2022. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2018-2022. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2024
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Generic Drug Utilization and Spending Among Medicare Part D Enrollees in 2022
Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report
Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how different population groups, including urban and rural residents, performed at a national level in order to inform future quality measure development and advance health equity. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how different population groups, including urban and rural residents, performed at a national level in order to inform future quality measure development and advance health equity. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural–Urban Differences in Out-of-Network Treatment Initiation and Engagement Rates for Substance Use Disorders
Explores disparities in access to substance use disorder treatments among privately insured individuals in rural and urban areas between 2016-2018. Compares rates of initial and ongoing treatment for alcohol use disorder, opioid use disorder, and other drug use disorders overall and from out-of-network providers for urban and rural patients.
Author(s): Eli Raver, Sheldon M. Retchin, Yiting Li, Andrew D. Carlo, Wendy Y. Xu
Citation: Health Services Research
Date: 03/2024
Type: Document
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Explores disparities in access to substance use disorder treatments among privately insured individuals in rural and urban areas between 2016-2018. Compares rates of initial and ongoing treatment for alcohol use disorder, opioid use disorder, and other drug use disorders overall and from out-of-network providers for urban and rural patients.
Author(s): Eli Raver, Sheldon M. Retchin, Yiting Li, Andrew D. Carlo, Wendy Y. Xu
Citation: Health Services Research
Date: 03/2024
Type: Document
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Merit-based Incentive Payment System (MIPS) 2024 Small Practice Eligibility and Participation Frequently Asked Questions
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Nonmetropolitan Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces in 2022
Policy brief describing differences in unsubsidized and net-of-subsidy premiums in 2022 between nonmetropolitan and metropolitan counties in Health Insurance Marketplace plan design and availability. Features statistics with breakdowns by metropolitan, micropolitan, and noncore areas.
Author(s): Abigail Barker, Ayushi Shrivastava, Eliot Jost, Timothy McBride, Keith Mueller
Date: 03/2024
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy brief describing differences in unsubsidized and net-of-subsidy premiums in 2022 between nonmetropolitan and metropolitan counties in Health Insurance Marketplace plan design and availability. Features statistics with breakdowns by metropolitan, micropolitan, and noncore areas.
Author(s): Abigail Barker, Ayushi Shrivastava, Eliot Jost, Timothy McBride, Keith Mueller
Date: 03/2024
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Breast Cancer Screening among Medicare Advantage Enrollees with Dementia
Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
Type: Document
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Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
Type: Document
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Use of In-Network Insurance Benefits Is Critical for Improving Retention in Telehealth-Based Buprenorphine Treatment
Evaluated 3,842 patients in an opioid use disorder (OUD) telehealth company to identify associations in insurance status and treatment program retention. Patient characteristic data includes breakdown by urbanicity, age, gender, race and ethnicity, buprenorphine status, and more.
Author(s): Arthur Robin Williams, Christopher Row, Lexie Minarik, et al.
Citation: Health Affairs Scholar, 2(3)
Date: 03/2024
Type: Document
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Evaluated 3,842 patients in an opioid use disorder (OUD) telehealth company to identify associations in insurance status and treatment program retention. Patient characteristic data includes breakdown by urbanicity, age, gender, race and ethnicity, buprenorphine status, and more.
Author(s): Arthur Robin Williams, Christopher Row, Lexie Minarik, et al.
Citation: Health Affairs Scholar, 2(3)
Date: 03/2024
Type: Document
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Inflation Reduction Act Research Series: Projected Impacts for Rural Medicare Enrollees
Provides an overview of how the Inflation Reduction Act (IRA) is intended to improve prescription drug affordability for Medicare enrollees. Describes Medicare enrollment in rural areas and rural residents' health status and access to care. Outlines the projected impact of drug-related IRA provisions for rural Medicare beneficiaries, including the expansion of financial assistance through the low-income subsidy program, out-of-pocket spending caps for insulin, changes in Part D benefit design, and more.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of how the Inflation Reduction Act (IRA) is intended to improve prescription drug affordability for Medicare enrollees. Describes Medicare enrollment in rural areas and rural residents' health status and access to care. Outlines the projected impact of drug-related IRA provisions for rural Medicare beneficiaries, including the expansion of financial assistance through the low-income subsidy program, out-of-pocket spending caps for insulin, changes in Part D benefit design, and more.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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