Rural Health
Resources by Topic: Medicare Advantage
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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Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies
Examines structures and approaches used by Medicare Advantage (MA) plans for dually enrolled and other high-cost beneficiaries. Includes case studies showcasing care models and how organizations are addressing social determinants of health for these beneficiaries. Discusses some challenges for rural areas and small community partnerships.
Author(s): Melony E. Sorbero, Ashley M. Kranz, Kathryn E. Bouskill, et al.
Date: 10/2018
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines structures and approaches used by Medicare Advantage (MA) plans for dually enrolled and other high-cost beneficiaries. Includes case studies showcasing care models and how organizations are addressing social determinants of health for these beneficiaries. Discusses some challenges for rural areas and small community partnerships.
Author(s): Melony E. Sorbero, Ashley M. Kranz, Kathryn E. Bouskill, et al.
Date: 10/2018
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Health Insurance Market Challenges
Policy brief examining challenges affecting rural health insurance markets with a focus on Medicare Advantage, Medicare Part D, Medicaid Managed Care, and the Health Insurance Marketplace. Provides recommendations related to health insurance availability, network development and adequacy, and consumer and provider engagement.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Policy brief examining challenges affecting rural health insurance markets with a focus on Medicare Advantage, Medicare Part D, Medicaid Managed Care, and the Health Insurance Marketplace. Provides recommendations related to health insurance availability, network development and adequacy, and consumer and provider engagement.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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MedPAC Report to the Congress: Medicare Payment Policy, 2018
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses Medicare Part D, Medicare Advantage, telehealth, payment incentive programs, and payment adequacy for healthcare facilities and services.
Additional links: Chapter 14 Online-Only Appendixes: The Medicare Prescription Drug Program (Part D): Status Report (March 2018 Report, Revised June 25, 2018), Chapter 16 Online-Only Appendixes: Mandated Report: Telehealth Services and the Medicare Program (March 2018 report), Errata Sheet: Table 9-7, Page 255 (March 2018 Report, Revised May 30, 2018)
Date: 03/2018
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 Medicare Part D, Medicare Advantage, telehealth, payment incentive programs, and payment adequacy for healthcare facilities and services.
Additional links: Chapter 14 Online-Only Appendixes: The Medicare Prescription Drug Program (Part D): Status Report (March 2018 Report, Revised June 25, 2018), Chapter 16 Online-Only Appendixes: Mandated Report: Telehealth Services and the Medicare Program (March 2018 report), Errata Sheet: Table 9-7, Page 255 (March 2018 Report, Revised May 30, 2018)
Date: 03/2018
Sponsoring organization: Medicare Payment Advisory Commission
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The Evolution of Private Plans in Medicare
Examines major policy changes affecting Medicare Advantage plans, and the impact of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care. Briefly discusses the challenges associate with providing risk-based plans in rural areas.
Author(s): Yash M. Patel, Stuart Guterman
Date: 12/2017
Sponsoring organization: Commonwealth Fund
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Examines major policy changes affecting Medicare Advantage plans, and the impact of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care. Briefly discusses the challenges associate with providing risk-based plans in rural areas.
Author(s): Yash M. Patel, Stuart Guterman
Date: 12/2017
Sponsoring organization: Commonwealth Fund
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MedPAC Report to the Congress: Medicare Payment Policy, 2016
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report. Focuses on payment adequacy, Medicare Advantage, and Medicare Part D.
Date: 03/2016
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report. Focuses on payment adequacy, Medicare Advantage, and Medicare Part D.
Date: 03/2016
Sponsoring organization: Medicare Payment Advisory Commission
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