Rural Health
Resources by Topic: Medicare Advantage
Risk Adjustment in the Medicare Advantage Population Using Encounter Data
Examines the Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk model by comparing 2016-2022 Traditional Medicare (TM) claims and Medicare Advantage (MA) encounter data. Analyzes differences in the TM-based model and MA-based model and discusses risk-adjusted MA payment, MA payment policy, and enrollment incentives for various populations, including rural.
Author(s): Caroline S. Carlin, Roger Feldman, Jeah Jung
Citation: Health Services Research, 61(5), e70165
Date: 10/2026
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Examines the Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk model by comparing 2016-2022 Traditional Medicare (TM) claims and Medicare Advantage (MA) encounter data. Analyzes differences in the TM-based model and MA-based model and discusses risk-adjusted MA payment, MA payment policy, and enrollment incentives for various populations, including rural.
Author(s): Caroline S. Carlin, Roger Feldman, Jeah Jung
Citation: Health Services Research, 61(5), e70165
Date: 10/2026
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September 2026 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2026 meeting. Covers the context for Medicare payment policy, issues relating to Medicare Part D and potential policy directions, MedPAC's work plan regarding ambulatory surgical centers, the use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage, and Medicare Advantage risk adjustment at the plan level.
Date: 09/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2026 meeting. Covers the context for Medicare payment policy, issues relating to Medicare Part D and potential policy directions, MedPAC's work plan regarding ambulatory surgical centers, the use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage, and Medicare Advantage risk adjustment at the plan level.
Date: 09/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage: Plan Options and Enrollment Trends in Arkansas
Explains how Medicare Advantage plans affect healthcare delivery, Medicare enrollment, and payment practices in Arkansas. Includes discussion of reimbursement challenges in rural hospitals.
Author(s): Jennifer Wessel, Chris Ray
Date: 09/2026
Sponsoring organization: Arkansas Center for Health Improvement
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Explains how Medicare Advantage plans affect healthcare delivery, Medicare enrollment, and payment practices in Arkansas. Includes discussion of reimbursement challenges in rural hospitals.
Author(s): Jennifer Wessel, Chris Ray
Date: 09/2026
Sponsoring organization: Arkansas Center for Health Improvement
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Geographical Access to Preferred Pharmacies in Medicare Part D
Analyzes access to preferred pharmacies in Medicare Part D prescription drug plans (PDPs) and Medicare Advantage PDPs (MAPDs). Utilizes multiple data sources to examine the nearest preferred pharmacy in MAPDs and stand-alone PDPs across rural and urban ZIP Code Tabulation Areas (ZCTAs). Discusses geographic disparities related to PDP and MAPD access.
Author(s): Pinka Chatterji, Yiran Han, Chun-Yu Ho
Citation: The American Journal of Managed Care, 32, 7
Date: 07/2026
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Analyzes access to preferred pharmacies in Medicare Part D prescription drug plans (PDPs) and Medicare Advantage PDPs (MAPDs). Utilizes multiple data sources to examine the nearest preferred pharmacy in MAPDs and stand-alone PDPs across rural and urban ZIP Code Tabulation Areas (ZCTAs). Discusses geographic disparities related to PDP and MAPD access.
Author(s): Pinka Chatterji, Yiran Han, Chun-Yu Ho
Citation: The American Journal of Managed Care, 32, 7
Date: 07/2026
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Health Care Access, Preventive Care, and Affordability Among Rural Adults With Cardiometabolic Conditions: Medicare Advantage Versus Traditional Medicare
Examines the differences in healthcare experiences for rural adults with cardiometabolic conditions who are enrolled in Medicare Advantage (MA) versus traditional Medicare. Utilizes 2021-2022 Medicare Current Beneficiary Survey data from 4,274 rural beneficiaries and analyzes MA versus traditional Medicare coverage related to issues such as healthcare access, preventive care, and affordability.
Author(s): Nicholas Chiu, Andrew Oseran, Archana P. Tale, Rishi K. Wadhera
Citation: Journal of the American Heart Association, 15, 15
Date: 07/2026
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Examines the differences in healthcare experiences for rural adults with cardiometabolic conditions who are enrolled in Medicare Advantage (MA) versus traditional Medicare. Utilizes 2021-2022 Medicare Current Beneficiary Survey data from 4,274 rural beneficiaries and analyzes MA versus traditional Medicare coverage related to issues such as healthcare access, preventive care, and affordability.
Author(s): Nicholas Chiu, Andrew Oseran, Archana P. Tale, Rishi K. Wadhera
Citation: Journal of the American Heart Association, 15, 15
Date: 07/2026
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Improving Access to Medicare Home Health Care: Key Policy Considerations
Highlights themes from interviews with 20 policy experts on home health agencies to identify factors contributing to declines in use of Medicare home health services. Discusses payment models, Medicare Advantage, workforce shortages, and family caregivers. Offers policy measures that may increase home health utilization.
Author(s): Barbara Lyons, Jane Andrews
Date: 07/2026
Sponsoring organization: Commonwealth Fund
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Highlights themes from interviews with 20 policy experts on home health agencies to identify factors contributing to declines in use of Medicare home health services. Discusses payment models, Medicare Advantage, workforce shortages, and family caregivers. Offers policy measures that may increase home health utilization.
Author(s): Barbara Lyons, Jane Andrews
Date: 07/2026
Sponsoring organization: Commonwealth Fund
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Rural Implications of Increased Medicare Beneficiary Enrollment in ACOs and MA Plans
Explores the relationship between Medicare Advantage (MA) enrollment and beneficiary attribution to Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). Describes the growth of ACO assignment and MA enrollment between 2013 and 2023 by county-level rurality. Compares the characteristics of micropolitan and noncore counties with high and low ACO and MA penetration in 2023. Discusses the implications of expanding MA and ACO enrollment in rural areas.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores the relationship between Medicare Advantage (MA) enrollment and beneficiary attribution to Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). Describes the growth of ACO assignment and MA enrollment between 2013 and 2023 by county-level rurality. Compares the characteristics of micropolitan and noncore counties with high and low ACO and MA penetration in 2023. Discusses the implications of expanding MA and ACO enrollment in rural areas.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2026
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Enrollment Update 2025
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2015-2025.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2015-2025.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Trends in Medicare Advantage Quality for Nonmetropolitan Enrollees, 2019-2023
Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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