Rural Health
Resources by Topic: Medicare Advantage
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)
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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)
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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
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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
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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
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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 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
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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
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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
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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
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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
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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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