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Rural Health
Resources by Topic: Health insurance

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
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 urban and rural residents performed at a national level in order to inform future quality measure development. 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
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
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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
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
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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, demographic characteristics, buprenorphine status, and more.
Author(s): Arthur Robin Williams, Christopher Row, Lexie Minarik, et al.
Citation: Health Affairs Scholar, 2(3)
Date: 03/2024
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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
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Sponsoring organization: Rural Health Research Gateway
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Material Financial Hardship and Insurance-Related Experiences among Utah's Rural and Urban Cancer Survivors
Examines material financial hardship, insurance type and suitability, insurance-related job lock, and access to care among 1,793 rural and urban cancer survivors in Utah, utilizing 2018-2021 survey data. Includes data breakdowns by race and ethnicity, treatment method, and other demographic and clinical factors.
Author(s): Heydon K. Kaddas, Morgan M. Millar, Kimberly A. Herget
Citation: Journal of Cancer Survivorship Research and Practice, 19, 1236-1243
Date: 02/2024
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Maternal Health in Rural America
White paper describing factors contributing to rural maternal health disparities, including financial barriers to providing obstetric services at rural hospitals, maternal health workforce shortages, access to care, and quality of care. Outlines policy considerations to increase access to maternal health services in rural areas.
Author(s): Hailey Waldman, Alexandra Zimmerman
Date: 02/2024
Sponsoring organization: National Rural Health Association
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