Rural Health
Resources by Topic: Medicare Advantage
Medicare Advantage Demographics Report, 2022
Summarizes demographics data on Medicare Advantage enrollment in 2022. Compares rural/urban residence of Medicare Advantage, Original Medicare, and dually eligible enrollees in Appendix B.
Date: 01/2025
Sponsoring organization: AHIP
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Summarizes demographics data on Medicare Advantage enrollment in 2022. Compares rural/urban residence of Medicare Advantage, Original Medicare, and dually eligible enrollees in Appendix B.
Date: 01/2025
Sponsoring organization: AHIP
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January 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 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 policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 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 policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluating Medicare Advantage Benchmark Setting Methodology on Rural Counties
Examines how the current Medicare Advantage benchmark setting process and methods impact rural and urban counties. Presents data on the Medicare fee-for-service spending quartiles by metropolitan and nonmetropolitan counties and the effects of caps on benchmark payments by geography.
Author(s): Dan M. Shane, Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 01/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines how the current Medicare Advantage benchmark setting process and methods impact rural and urban counties. Presents data on the Medicare fee-for-service spending quartiles by metropolitan and nonmetropolitan counties and the effects of caps on benchmark payments by geography.
Author(s): Dan M. Shane, Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 01/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Medicare Advantage Enrollment Update 2024
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2014-2024.
Author(s): Fred Ullrich, Keith Mueller
Date: 01/2025
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) plans by metropolitan and nonmetropolitan location and plan type, from 2014-2024.
Author(s): Fred Ullrich, Keith Mueller
Date: 01/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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October 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2024 meeting. Covers an analysis of Medicare beneficiaries in nursing homes, findings from MedPAC's annual beneficiary and provider focus groups, supplemental benefits in Medicare Advantage, a work plan for a mandated final report on the impact of recent changes to the home health prospective payment system, and initial estimates of home healthcare use among Medicare Advantage enrollees. Includes rural references throughout.
Additional links: Medicare Beneficiaries in Nursing Homes - Presentation Slides
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2024 meeting. Covers an analysis of Medicare beneficiaries in nursing homes, findings from MedPAC's annual beneficiary and provider focus groups, supplemental benefits in Medicare Advantage, a work plan for a mandated final report on the impact of recent changes to the home health prospective payment system, and initial estimates of home healthcare use among Medicare Advantage enrollees. Includes rural references throughout.
Additional links: Medicare Beneficiaries in Nursing Homes - Presentation Slides
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Predictors of Telehealth Use after the Minnesota Telehealth Act: Analysis Using the Minnesota All Payer Claims Database
Examines factors contributing to telehealth use among commercially insured and Medicare Advantage patients in Minnesota. Factors evaluated include age, sex, various chronic health conditions, rurality, broadband access, and more.
Author(s): Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, et al.
Citation: Health Affairs Scholar, 2(8)
Date: 08/2024
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Examines factors contributing to telehealth use among commercially insured and Medicare Advantage patients in Minnesota. Factors evaluated include age, sex, various chronic health conditions, rurality, broadband access, and more.
Author(s): Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, et al.
Citation: Health Affairs Scholar, 2(8)
Date: 08/2024
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2024
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Plan Growth in Rural America: Availability of Supplemental Benefits
Examines supplemental benefits of Medicare Advantage (MA) plans, categorized as traditional health benefit, expanded health benefit, and special benefit for the chronically ill. Utilizes 2022 Centers for Medicare & Medicaid Services (CMS) data to analyze availability of and benefits offered in MA plans according to metro, micro, and noncore location. Includes county-level maps of MA data organized by U.S. region.
Author(s): Edmer Lazaro, Dan M. Shane, Fred Ullrich, Keith Mueller
Date: 05/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines supplemental benefits of Medicare Advantage (MA) plans, categorized as traditional health benefit, expanded health benefit, and special benefit for the chronically ill. Utilizes 2022 Centers for Medicare & Medicaid Services (CMS) data to analyze availability of and benefits offered in MA plans according to metro, micro, and noncore location. Includes county-level maps of MA data organized by U.S. region.
Author(s): Edmer Lazaro, Dan M. Shane, Fred Ullrich, Keith Mueller
Date: 05/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Ground Ambulance Industry Trends, 2017–2022: Analysis of Medicare Fee-for-Service Claims
Explores whether ground ambulance organizations have changed between 2017 and 2022. Examines trends in the number of ground ambulance transports paid for by traditional fee-for-service Medicare, the characteristics of organizations billing Medicare for these services, the most common diagnosis codes reported on Medicare ground ambulance claims, and the share of transports to or from an end-stage renal disease (ESRD) facility. Discusses how the growth in Medicare Advantage enrollment could impact the volume of traditional Medicare ground ambulance transports. Includes data on ground ambulance transports by service area population density.
Author(s): Petra W. Rasmussen, Jonathan Cantor, Jennifer Gildner, Sara Heins, Andrew W. Mulcahy
Date: 04/2024
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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Explores whether ground ambulance organizations have changed between 2017 and 2022. Examines trends in the number of ground ambulance transports paid for by traditional fee-for-service Medicare, the characteristics of organizations billing Medicare for these services, the most common diagnosis codes reported on Medicare ground ambulance claims, and the share of transports to or from an end-stage renal disease (ESRD) facility. Discusses how the growth in Medicare Advantage enrollment could impact the volume of traditional Medicare ground ambulance transports. Includes data on ground ambulance transports by service area population density.
Author(s): Petra W. Rasmussen, Jonathan Cantor, Jennifer Gildner, Sara Heins, Andrew W. Mulcahy
Date: 04/2024
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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Survey Emphasizes Scale and Significance of the RHC Program
Summarizes results of a 2024 national survey of 930 Rural Health Clinics. Presents data on the average payer mix, use and attitude toward telehealth services, Medicare Advantage (MA) contract structures, and MA reimbursement relative to traditional Medicare reimbursement, and more.
Additional links: NARHC 2024 Policy Survey Results
Date: 04/2024
Sponsoring organization: National Association of Rural Health Clinics
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Summarizes results of a 2024 national survey of 930 Rural Health Clinics. Presents data on the average payer mix, use and attitude toward telehealth services, Medicare Advantage (MA) contract structures, and MA reimbursement relative to traditional Medicare reimbursement, and more.
Additional links: NARHC 2024 Policy Survey Results
Date: 04/2024
Sponsoring organization: National Association of Rural Health Clinics
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