Rural Health
Resources by Topic: Medicare Advantage
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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Community Factors Associated With Telemedicine Use During the COVID-19 Pandemic
Examines the association of telemedicine use with community factors among people with commercial or Medicare Advantage insurance. Features a county-level map showing variation in the percentage of telemedicine visits during COVID-19, and statistics with breakdowns by low, middle, and high population density.
Author(s): Sadiq Y. Patel, Sherri Rose, Michael L. Barnett, et al.
Citation: JAMA Network Open, 4(5)
Date: 05/2021
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Examines the association of telemedicine use with community factors among people with commercial or Medicare Advantage insurance. Features a county-level map showing variation in the percentage of telemedicine visits during COVID-19, and statistics with breakdowns by low, middle, and high population density.
Author(s): Sadiq Y. Patel, Sherri Rose, Michael L. Barnett, et al.
Citation: JAMA Network Open, 4(5)
Date: 05/2021
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MedPAC Report to the Congress: Medicare Payment Policy, 2021
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. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
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. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Availability of Supplemental Benefits in Medicare Advantage Plans in Rural and Urban Areas
Examines differences in Medicare Advantage (MA) plans with supplemental benefits that are available to enrollees in nonmetropolitan and metropolitan areas. Features statistics including average number of organizations offering MA plans, proportion of MA plans offering supplemental benefits, and MA plan premiums as of 2020, with breakdowns by noncore, micropolitan, and metropolitan counties.
Author(s): Jason Semprini, Fred Ullrich, Keith J. Mueller
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines differences in Medicare Advantage (MA) plans with supplemental benefits that are available to enrollees in nonmetropolitan and metropolitan areas. Features statistics including average number of organizations offering MA plans, proportion of MA plans offering supplemental benefits, and MA plan premiums as of 2020, with breakdowns by noncore, micropolitan, and metropolitan counties.
Author(s): Jason Semprini, Fred Ullrich, Keith J. Mueller
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rethinking Rural Health: FY 2020 Year in Review
Provides an overview of Centers for Medicaid and Medicare Services (CMS) programs and activities that have affected rural health and healthcare in fiscal year 2020. Focuses on nine priority areas: COVID-19, maternal health, Medicare Advantage (MA) and the Federally-facilitated Marketplace (FFM), quality improvement, practitioner engagement, patient empowerment and person-centered care, Medicare and Medicaid payment and policy, models and demonstrations, and telehealth.
Date: 11/2020
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of Centers for Medicaid and Medicare Services (CMS) programs and activities that have affected rural health and healthcare in fiscal year 2020. Focuses on nine priority areas: COVID-19, maternal health, Medicare Advantage (MA) and the Federally-facilitated Marketplace (FFM), quality improvement, practitioner engagement, patient empowerment and person-centered care, Medicare and Medicaid payment and policy, models and demonstrations, and telehealth.
Date: 11/2020
Sponsoring organization: Centers for Medicare & Medicaid Services
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Medicare Advantage Versus the Traditional Medicare Program: Costs of Inpatient Stays, 2009–2017
Examines the costs of hospital inpatient stays among patients 65 years of age and older with a primary expected payer of Medicare Advantage compared to traditional Medicare, based on data from 18 states. Includes data by location of patient residence for rural, micropolitan, small metropolitan, and large metropolitan areas.
Author(s): Brian J. Moore, Lan Liang
Date: 08/2020
Sponsoring organization: Agency for Healthcare Research and Quality
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Examines the costs of hospital inpatient stays among patients 65 years of age and older with a primary expected payer of Medicare Advantage compared to traditional Medicare, based on data from 18 states. Includes data by location of patient residence for rural, micropolitan, small metropolitan, and large metropolitan areas.
Author(s): Brian J. Moore, Lan Liang
Date: 08/2020
Sponsoring organization: Agency for Healthcare Research and Quality
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