Rural Health
Resources by Topic: Medicare Advantage
Utilization of Z Codes for Social Determinants of Health among a Sample of Medicare Advantage Enrollees, 2017 and 2019
Examines the use of Z codes for social determinants of health in a sample of Medicare Advantage (MA) enrollees from 2016 through 2019. Identifies the five most-used Z codes among MA enrollees, including the percent of enrollees and claims with these Z codes in 2017 and 2019. Presents data on the proportion of MA enrollees with Z code claims in 2017 and 2019 across demographic characteristics, including rurality, place of service, and provider type.
Date: 04/2022
Sponsoring organization: Centers for Medicare & Medicaid Services
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Examines the use of Z codes for social determinants of health in a sample of Medicare Advantage (MA) enrollees from 2016 through 2019. Identifies the five most-used Z codes among MA enrollees, including the percent of enrollees and claims with these Z codes in 2017 and 2019. Presents data on the proportion of MA enrollees with Z code claims in 2017 and 2019 across demographic characteristics, including rurality, place of service, and provider type.
Date: 04/2022
Sponsoring organization: Centers for Medicare & Medicaid Services
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March 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2022 meeting. Covers findings from MedPAC's annual beneficiary and clinician focus groups, Medicare payment policies to support safety net providers, opportunities to strengthen the geriatric workforce, integrating episode-based payment with population-based payment, and improving Medicare Advantage risk adjustment. Includes rural references throughout.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2022 meeting. Covers findings from MedPAC's annual beneficiary and clinician focus groups, Medicare payment policies to support safety net providers, opportunities to strengthen the geriatric workforce, integrating episode-based payment with population-based payment, and improving Medicare Advantage risk adjustment. Includes rural references throughout.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2022
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 healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
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 healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Trends in Racial, Ethnic, Sex, and Rural-Urban Inequities in Health Care in Medicare Advantage: 2009-2018
Presents an analysis of historical trends in inequities by race and ethnicity, sex, and rural-urban residence among Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide. Uses patient experience and clinical care measures to examine how inequities in healthcare have changed between 2009 and 2018, how scores for each beneficiary group have changed over time, and which inequities remained in 2018.
Date: 12/2021
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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Presents an analysis of historical trends in inequities by race and ethnicity, sex, and rural-urban residence among Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide. Uses patient experience and clinical care measures to examine how inequities in healthcare have changed between 2009 and 2018, how scores for each beneficiary group have changed over time, and which inequities remained in 2018.
Date: 12/2021
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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Medicare Telemedicine Snapshot
Presents data on telemedicine utilization by Medicare beneficiaries from March 1, 2020 to February 28, 2021, including pre- and post-pandemic rates of accessing telehealth services, trends in e-visits and virtual check-ins, geographic breakdowns including rural and urban residence, and beneficiary characteristics. Uses data from Medicare Fee-for-Service (FFS) claims, Medicare Advantage (MA) encounters, and Medicare enrollment.
Date: 12/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Presents data on telemedicine utilization by Medicare beneficiaries from March 1, 2020 to February 28, 2021, including pre- and post-pandemic rates of accessing telehealth services, trends in e-visits and virtual check-ins, geographic breakdowns including rural and urban residence, and beneficiary characteristics. Uses data from Medicare Fee-for-Service (FFS) claims, Medicare Advantage (MA) encounters, and Medicare enrollment.
Date: 12/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Annual Influenza Vaccination Disparities in Medicare Beneficiaries
Explores disparities among Medicare beneficiaries who received influenza vaccinations in 2019 and 2020. Presents data on influenza vaccinations by race and ethnicity, sex, and urban-rural residence. Compares data for Medicare fee-for-service and Medicare Advantage enrollees.
Date: 11/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Explores disparities among Medicare beneficiaries who received influenza vaccinations in 2019 and 2020. Presents data on influenza vaccinations by race and ethnicity, sex, and urban-rural residence. Compares data for Medicare fee-for-service and Medicare Advantage enrollees.
Date: 11/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Network Adequacy for Behavioral Health: Existing Standards and Considerations for Designing Standards
Summarizes findings from a technical expert panel and an environmental scan to examine federal and state network adequacy standards for behavioral health across Medicare Advantage, Medicaid managed care, and commercial insurance. Presents considerations and principles for designing, monitoring, and enforcing additional behavioral health network adequacy standards.
Author(s): Katharine Bradley, Allison Wishon, Alexandra C. Donnelly, Amanda Lechner
Date: 11/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Summarizes findings from a technical expert panel and an environmental scan to examine federal and state network adequacy standards for behavioral health across Medicare Advantage, Medicaid managed care, and commercial insurance. Presents considerations and principles for designing, monitoring, and enforcing additional behavioral health network adequacy standards.
Author(s): Katharine Bradley, Allison Wishon, Alexandra C. Donnelly, Amanda Lechner
Date: 11/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Medicare Advantage Enrollment Update 2021
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
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) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy
Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2021
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Chapter 5 presents an interim report on Medicare beneficiaries' access to care in rural areas. Also includes chapters on Medicare Advantage benchmark policy, alternative payment models, private equity and Medicare, the skilled nursing facility value-based purchasing program, indirect medical education payments, Medicare coverage of vaccines, separately payable drugs in the hospital outpatient prospective payment system, clinical laboratory fee schedule payment rates, and the relationship between clinician services and other Medicare services.
Additional links: Executive Summary
Date: 06/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Chapter 5 presents an interim report on Medicare beneficiaries' access to care in rural areas. Also includes chapters on Medicare Advantage benchmark policy, alternative payment models, private equity and Medicare, the skilled nursing facility value-based purchasing program, indirect medical education payments, Medicare coverage of vaccines, separately payable drugs in the hospital outpatient prospective payment system, clinical laboratory fee schedule payment rates, and the relationship between clinician services and other Medicare services.
Additional links: Executive Summary
Date: 06/2021
Sponsoring organization: Medicare Payment Advisory Commission
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