Rural Health
Resources by Topic: Medicare Advantage
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2020
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Access to Medicare Part D Plans: A Comparison of Metropolitan and Nonmetropolitan Areas
Policy brief focusing on the types of Medicare Part D plans offered in metropolitan, micropolitan, and noncore locations. Offers comparisons between stand-alone plans and Medicare Advantage plans, in terms of premiums, benefits, and the manner in which these plans are offered.
Author(s): Mochamad Nataliansyah, Abiodun Salako, Fred Ullrich, Keith Mueller
Date: 05/2020
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy brief focusing on the types of Medicare Part D plans offered in metropolitan, micropolitan, and noncore locations. Offers comparisons between stand-alone plans and Medicare Advantage plans, in terms of premiums, benefits, and the manner in which these plans are offered.
Author(s): Mochamad Nataliansyah, Abiodun Salako, Fred Ullrich, Keith Mueller
Date: 05/2020
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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As It Grows, Medicare Advantage is Enrolling More Low-Income and Medically Complex Beneficiaries
Examines how the demographics, socioeconomic status, and clinical characteristics of Medicare Advantage enrollees changed between 2012 and 2015. Explores how these changes related to changes in healthcare utilization and performance during this time.
Author(s): Christie Teigland, Zulkarnain Pulungan, Tanya Shah, Eric Schneider, Shawn Bishop
Date: 05/2020
Sponsoring organization: Commonwealth Fund
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Examines how the demographics, socioeconomic status, and clinical characteristics of Medicare Advantage enrollees changed between 2012 and 2015. Explores how these changes related to changes in healthcare utilization and performance during this time.
Author(s): Christie Teigland, Zulkarnain Pulungan, Tanya Shah, Eric Schneider, Shawn Bishop
Date: 05/2020
Sponsoring organization: Commonwealth Fund
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Health Care Provisions in the Families First Coronavirus Response Act, P.L. 116-127
Provides an overview of the healthcare-related provisions of the Families First Coronavirus Response Act, passed in response to the COVID-19 pandemic. Focuses on coverage of COVID-19 testing and related items for individuals covered by Medicare, Medicare Advantage, Medicaid, CHIP, TRICARE, Veterans healthcare, the IHS, and most private plans. Includes a discussion of changes to Medicare coverage of telehealth services.
Date: 04/2020
Sponsoring organization: Congressional Research Service
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Provides an overview of the healthcare-related provisions of the Families First Coronavirus Response Act, passed in response to the COVID-19 pandemic. Focuses on coverage of COVID-19 testing and related items for individuals covered by Medicare, Medicare Advantage, Medicaid, CHIP, TRICARE, Veterans healthcare, the IHS, and most private plans. Includes a discussion of changes to Medicare coverage of telehealth services.
Date: 04/2020
Sponsoring organization: Congressional Research Service
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MedPAC Report to the Congress: Medicare Payment Policy, 2020
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: 03/2020
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: 03/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Demographics Report, 2016
Summarizes demographics data on Medicare Advantage enrollment. Addresses rural/urban differences in Appendix B.
Date: 05/2019
Sponsoring organization: AHIP
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Summarizes demographics data on Medicare Advantage enrollment. Addresses rural/urban differences in Appendix B.
Date: 05/2019
Sponsoring organization: AHIP
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MedPAC Report to the Congress: Medicare Payment Policy, 2019
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses opioids, Medicare Part D, Medicare Advantage, Medicare's quality incentive program for hospitals, and payment adequacy for healthcare facilities and services.
Date: 03/2019
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 opioids, Medicare Part D, Medicare Advantage, Medicare's quality incentive program for hospitals, and payment adequacy for healthcare facilities and services.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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2019 Telehealth Reimbursement
Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Market Concentration and Potential Competition in Medicare Advantage
Examines competition among Medicare Advantage plans using county-level data on plans offered and enrollment for 2009-2017. Addresses market concentration in rural areas. Discusses the importance of plan competition to keep insurance prices down.
Author(s): Richard G. Frank, Thomas G. McGuire
Date: 02/2019
Sponsoring organization: Commonwealth Fund
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Examines competition among Medicare Advantage plans using county-level data on plans offered and enrollment for 2009-2017. Addresses market concentration in rural areas. Discusses the importance of plan competition to keep insurance prices down.
Author(s): Richard G. Frank, Thomas G. McGuire
Date: 02/2019
Sponsoring organization: Commonwealth Fund
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Neighborhood Disadvantage and Chronic Disease Management
Assesses the relationship between neighborhood disadvantage and control of blood pressure, diabetes, and cholesterol in the Medicare Advantage population. Features demographic statistics with breakdowns by 6 levels of population density.
Author(s): Shayla N.M. Durfey, Amy J.H. Kind, William R. Buckingham, Eva H. DuGoff, Amal N. Trivedi
Citation: Health Services Research, 54(1), Part II, 206-216
Date: 02/2019
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Assesses the relationship between neighborhood disadvantage and control of blood pressure, diabetes, and cholesterol in the Medicare Advantage population. Features demographic statistics with breakdowns by 6 levels of population density.
Author(s): Shayla N.M. Durfey, Amy J.H. Kind, William R. Buckingham, Eva H. DuGoff, Amal N. Trivedi
Citation: Health Services Research, 54(1), Part II, 206-216
Date: 02/2019
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