Rural Health
Resources by Topic: Medicare Advantage
Provider-Level Variation in the Delivery of Primary Care Telehealth for the Rural Medicare Advantage Population
Results of a study comparing use of telehealth primary care between rural and nonrural Medicare Advantage (MA) beneficiaries by providers' level of telehealth delivery. Based on data from claims for MA beneficiaries enrolled in Humana Inc. plans from January 2021 to June 2024.
Author(s): Debra Bozzi, Amanda Sutherland, Melanie Canterberry, Emily Boudreau, Gosia Sylwestrzak
Citation: The Journal of Rural Health, 42(1), e70127
Date: 02/2026
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Results of a study comparing use of telehealth primary care between rural and nonrural Medicare Advantage (MA) beneficiaries by providers' level of telehealth delivery. Based on data from claims for MA beneficiaries enrolled in Humana Inc. plans from January 2021 to June 2024.
Author(s): Debra Bozzi, Amanda Sutherland, Melanie Canterberry, Emily Boudreau, Gosia Sylwestrzak
Citation: The Journal of Rural Health, 42(1), e70127
Date: 02/2026
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Health Panel Comment Letter - Contract Year 2027 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs
Offers comments in response to a November 28, 2025, proposed rule regarding policy and technical changes to the Medicare Advantage, Medicare Prescription Drug Benefit, and Medicare Cost Plan programs for contract year 2027. Includes data on trends in chronic condition special need plans (C-SNPs) and institutional special needs plans (I-SNPs) between 2016 and 2025 and MA plan offerings by county metropolitan status.
Date: 01/2026
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to a November 28, 2025, proposed rule regarding policy and technical changes to the Medicare Advantage, Medicare Prescription Drug Benefit, and Medicare Cost Plan programs for contract year 2027. Includes data on trends in chronic condition special need plans (C-SNPs) and institutional special needs plans (I-SNPs) between 2016 and 2025 and MA plan offerings by county metropolitan status.
Date: 01/2026
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicare Advantage Demographics Report, 2023
Summarizes demographics data on Medicare Advantage enrollment in 2023. Compares rural/urban residence of Medicare Advantage, Original Medicare, and dually eligible enrollees in Appendix B.
Date: 01/2026
Sponsoring organization: AHIP
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Summarizes demographics data on Medicare Advantage enrollment in 2023. Compares rural/urban residence of Medicare Advantage, Original Medicare, and dually eligible enrollees in Appendix B.
Date: 01/2026
Sponsoring organization: AHIP
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January 2026 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2026 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as mandated reports on changes to the home health prospective payment system and dual-eligible special needs plans. Includes rural references and considerations throughout.
Date: 01/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2026 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as mandated reports on changes to the home health prospective payment system and dual-eligible special needs plans. Includes rural references and considerations throughout.
Date: 01/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings
Offers an overview of Medicare Advantage plan availability across the country for 2026. Discusses how many plans are available, who is offering plans, and costs. Offers data for rural and urban areas and county-level data.
Date: 12/2025
Sponsoring organization: KFF
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Offers an overview of Medicare Advantage plan availability across the country for 2026. Discusses how many plans are available, who is offering plans, and costs. Offers data for rural and urban areas and county-level data.
Date: 12/2025
Sponsoring organization: KFF
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Rural-Urban Differences in Barriers to Care and Utilization of Preventive Care Among Traditional Medicare and Medicare Advantage Beneficiaries
Discusses the differences in barriers to care and preventive care utilization for older adults enrolled in traditional Medicare versus Medicare Advantage and makes a rural-urban comparison. Explores barriers to care, such as quality of care and out-of-pocket costs, as well as care utilization, such as regular vaccinations, cancer screenings, and cholesterol tests, among others.
Author(s): Gawain J. Williams, Dan M. Shane, Whitney E. Zahnd, Keith J. Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Discusses the differences in barriers to care and preventive care utilization for older adults enrolled in traditional Medicare versus Medicare Advantage and makes a rural-urban comparison. Explores barriers to care, such as quality of care and out-of-pocket costs, as well as care utilization, such as regular vaccinations, cancer screenings, and cholesterol tests, among others.
Author(s): Gawain J. Williams, Dan M. Shane, Whitney E. Zahnd, Keith J. Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Medicare Payment Basics: Medicare Advantage Program Payment System
Overview of Medicare payments to Medicare Advantage (MA) local and regional plans discussing the methods for determining Medicare payments to both plans.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments to Medicare Advantage (MA) local and regional plans discussing the methods for determining Medicare payments to both plans.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries
Explores how provider networks vary across Medicare Advantage plans and when compared to traditional Medicare. Examines the share of physicians available to Medicare Advantage enrollees as a share of physicians available to traditional Medicare beneficiaries by analyzing Medicare Advantage provider directories for 2022. Includes information on the availability of physicians to Medicare Advantage enrollees and traditional Medicare beneficiaries in rural counties.
Author(s): Matthew Rae, Jeannie Fuglesten Biniek, Tricia Neuman, Karen Pollitz
Date: 10/2025
Sponsoring organization: KFF
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Explores how provider networks vary across Medicare Advantage plans and when compared to traditional Medicare. Examines the share of physicians available to Medicare Advantage enrollees as a share of physicians available to traditional Medicare beneficiaries by analyzing Medicare Advantage provider directories for 2022. Includes information on the availability of physicians to Medicare Advantage enrollees and traditional Medicare beneficiaries in rural counties.
Author(s): Matthew Rae, Jeannie Fuglesten Biniek, Tricia Neuman, Karen Pollitz
Date: 10/2025
Sponsoring organization: KFF
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Many Medicare Advantage and Medicaid Managed Care Plans Have Limited Behavioral Health Provider Networks and Inactive Providers
Examines the availability of behavioral health providers in selected Medicare Advantage (MA) and Medicaid managed care networks in 2023. Analyzes provider network lists and MA and Medicaid encounter data for four MA and two Medicaid managed care plans from 10 selected urban and rural counties across five states. Describes the proportion of the behavioral health workforce in each county included in the plans' networks. Discusses the extent to which managed care plans had inactive providers in their network and why these providers did not deliver services to enrollees. Includes data on the percentage of inactive providers in rural and urban counties. Offers recommendations to monitor and improve the accuracy of provider networks.
Additional links: Report Highlights
Date: 10/2025
Sponsoring organization: Office of Inspector General (HHS)
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Examines the availability of behavioral health providers in selected Medicare Advantage (MA) and Medicaid managed care networks in 2023. Analyzes provider network lists and MA and Medicaid encounter data for four MA and two Medicaid managed care plans from 10 selected urban and rural counties across five states. Describes the proportion of the behavioral health workforce in each county included in the plans' networks. Discusses the extent to which managed care plans had inactive providers in their network and why these providers did not deliver services to enrollees. Includes data on the percentage of inactive providers in rural and urban counties. Offers recommendations to monitor and improve the accuracy of provider networks.
Additional links: Report Highlights
Date: 10/2025
Sponsoring organization: Office of Inspector General (HHS)
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Unfairness Toward Rural Beneficiaries in Medicare's Hierarchical Conditions Categories Score
Evaluates the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) to determine its usefulness in accurately predicting risk for rural and urban patients. Assesses rural and urban risk by mortality rates and compares findings with HCC's measure of spending to identify risk. Discusses implications of findings related to reimbursement rates, healthcare access, social determinants of health, and Medicare Advantage enrollment. Offers potential solutions to address study findings.
Author(s): Ravi B. Parikh, Kristin A. Linn, Junning Liang, et al
Citation: Health Affairs Scholar, 3(9)
Date: 09/2025
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Evaluates the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) to determine its usefulness in accurately predicting risk for rural and urban patients. Assesses rural and urban risk by mortality rates and compares findings with HCC's measure of spending to identify risk. Discusses implications of findings related to reimbursement rates, healthcare access, social determinants of health, and Medicare Advantage enrollment. Offers potential solutions to address study findings.
Author(s): Ravi B. Parikh, Kristin A. Linn, Junning Liang, et al
Citation: Health Affairs Scholar, 3(9)
Date: 09/2025
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