Rural Health
Resources by Topic: Medicare Advantage
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care
Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Sponsoring organization: Office of Inspector General (HHS)
view details
Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Sponsoring organization: Office of Inspector General (HHS)
view details
March 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2024 meeting. Covers proposed approaches and research topics related to evaluating rural hospital and clinician payment policies, an assessment of the completeness of Medicare Advantage (MA) encounter data and other sources of information about MA enrollees' healthcare utilization, a preliminary analysis of MA quality, the Acute Hospital Care at Home program, and Medicare inpatient psychiatric service trends and issues.
Additional links: Rural Hospital and Clinician Payment Policy: A Workplan for 2024–2025 - Presentation Slides
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
view details
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2024 meeting. Covers proposed approaches and research topics related to evaluating rural hospital and clinician payment policies, an assessment of the completeness of Medicare Advantage (MA) encounter data and other sources of information about MA enrollees' healthcare utilization, a preliminary analysis of MA quality, the Acute Hospital Care at Home program, and Medicare inpatient psychiatric service trends and issues.
Additional links: Rural Hospital and Clinician Payment Policy: A Workplan for 2024–2025 - Presentation Slides
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
view details
MedPAC Report to the Congress: Medicare Payment Policy, 2024
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 Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
view details
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 Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
view details
Breast Cancer Screening among Medicare Advantage Enrollees with Dementia
Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
view details
Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
view details
Medicare Advantage: It's Here, Now What?
Slides from a presentation at the 2024 National Rural Health Association's Policy Institute conference that discuss Medicare Advantage, with data on eligibility and enrollment percentages depicted for select states as well as by metro versus nonmetro location.
Author(s): Keith J. Mueller
Date: 02/2024
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
view details
Slides from a presentation at the 2024 National Rural Health Association's Policy Institute conference that discuss Medicare Advantage, with data on eligibility and enrollment percentages depicted for select states as well as by metro versus nonmetro location.
Author(s): Keith J. Mueller
Date: 02/2024
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
view details