Rural Health
Resources by Topic: Medicare Advantage
Policy and Research Update: Financial Models for Rural Hospitals
Slides presented at the 2024 American Hospital Association's Rural Health Care Leadership conference that discuss healthcare payment policies, value-based care, alternative payment models, Medicare Advantage, and more. Provides discussion on how rural hospitals are adapting to financial models, statistics on insurance adoption, and related resources.
Author(s): Christina Campos, Kristen Dillon, Keith Mueller, George Pink
Date: 02/2024
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
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Slides presented at the 2024 American Hospital Association's Rural Health Care Leadership conference that discuss healthcare payment policies, value-based care, alternative payment models, Medicare Advantage, and more. Provides discussion on how rural hospitals are adapting to financial models, statistics on insurance adoption, and related resources.
Author(s): Christina Campos, Kristen Dillon, Keith Mueller, George Pink
Date: 02/2024
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
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Unrelenting Pressure Pushes Rural Safety Net Crisis Into Uncharted Territory
Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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The Effects of Medicare Advantage on Rural Hospitals With St. Bernards Healthcare
Podcast episode featuring a discussion with Chris Barber, president and CEO of St. Bernards Healthcare, which serves communities in Arkansas and Missouri. Describes how certain Medicare Advantage plan practices can create problems for rural hospitals, health systems, and patients.
Date: 01/2024
Sponsoring organization: American Hospital Association
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Podcast episode featuring a discussion with Chris Barber, president and CEO of St. Bernards Healthcare, which serves communities in Arkansas and Missouri. Describes how certain Medicare Advantage plan practices can create problems for rural hospitals, health systems, and patients.
Date: 01/2024
Sponsoring organization: American Hospital Association
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January 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, and inpatient rehabilitation facility services. Discusses status reports on ambulatory surgical centers, Medicare Part D, and the Medicare Advantage program, as well as policy options for standardized benefits in Medicare Advantage plans. Includes rural references and considerations throughout.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services
Date: 01/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, and inpatient rehabilitation facility services. Discusses status reports on ambulatory surgical centers, Medicare Part D, and the Medicare Advantage program, as well as policy options for standardized benefits in Medicare Advantage plans. Includes rural references and considerations throughout.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services
Date: 01/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Demographics Report, 2021
Summarizes demographics data on Medicare Advantage enrollment in 2021. Compares rural/urban residence of Medicare Advantage, Original Medicare, and dually eligible enrollees in Appendix B.
Date: 01/2024
Sponsoring organization: AHIP
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Summarizes demographics data on Medicare Advantage enrollment in 2021. Compares rural/urban residence of Medicare Advantage, Original Medicare, and dually eligible enrollees in Appendix B.
Date: 01/2024
Sponsoring organization: AHIP
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Medicare Advantage Growth and Its Impact on Rural Health Care
Policy position paper regarding the impact of the increase of Medicare Advantage (MA) enrollment in rural areas on healthcare access, delivery, and financial viability. Offers policy recommendations to support rural MA beneficiaries, healthcare providers, and hospitals at a local level, as well as rural healthcare provision within the MA framework.
Author(s): Carrie Shaver, Kevin Lambing, Lisa Rantz
Date: 12/2023
Sponsoring organization: National Rural Health Association
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Policy position paper regarding the impact of the increase of Medicare Advantage (MA) enrollment in rural areas on healthcare access, delivery, and financial viability. Offers policy recommendations to support rural MA beneficiaries, healthcare providers, and hospitals at a local level, as well as rural healthcare provision within the MA framework.
Author(s): Carrie Shaver, Kevin Lambing, Lisa Rantz
Date: 12/2023
Sponsoring organization: National Rural Health Association
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Disparities in Health Measures By Race and Ethnicity Among Beneficiaries in Medicare Advantage: A Review of the Literature
Summarizes the results of a review of 20 studies published between January 2018 and April 2023 to examine racial and ethnic disparities in quality of care and beneficiary experience among Medicare Advantage (MA) plan enrollees. Discusses gaps in data and in the literature that contribute to challenges in understanding racial and ethnic disparities in MA quality and beneficiary experience. Includes information on nine studies that explored 25 measures of quality of care received by American Indian and Alaska Native enrollees and two studies that examined disparities among MA enrollees in rural areas by race and ethnicity.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek, Juliette Cubanski, Tricia Neuman
Date: 12/2023
Sponsoring organization: KFF
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Summarizes the results of a review of 20 studies published between January 2018 and April 2023 to examine racial and ethnic disparities in quality of care and beneficiary experience among Medicare Advantage (MA) plan enrollees. Discusses gaps in data and in the literature that contribute to challenges in understanding racial and ethnic disparities in MA quality and beneficiary experience. Includes information on nine studies that explored 25 measures of quality of care received by American Indian and Alaska Native enrollees and two studies that examined disparities among MA enrollees in rural areas by race and ethnicity.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek, Juliette Cubanski, Tricia Neuman
Date: 12/2023
Sponsoring organization: KFF
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Medicare Advantage in Rural Areas: Implications for Hospital Sustainability
Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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November 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) November 2023 meeting. Covers the Rural Emergency Hospital (REH) designation, dual-eligible special needs plans (D-SNPs), MedPAC's proposed work plan on hospice and end-of-life care, Medicare coverage and payment for software as a medical service, and access and favorable selection in Medicare Advantage. Includes rural references and considerations throughout.
Date: 11/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) November 2023 meeting. Covers the Rural Emergency Hospital (REH) designation, dual-eligible special needs plans (D-SNPs), MedPAC's proposed work plan on hospice and end-of-life care, Medicare coverage and payment for software as a medical service, and access and favorable selection in Medicare Advantage. Includes rural references and considerations throughout.
Date: 11/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Enrollment Update 2023
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2014-2023.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 11/2023
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 2014-2023.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 11/2023
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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