Rural Health
Resources by Topic: Medicare Advantage
Accountable Health Communities (AHC) Model Evaluation: Second Evaluation Report
Provides an overview of the Accountable Health Communities (ACH) Model, which tests whether identifying and addressing core health-related social needs (HRSNs) of community-dwelling beneficiaries improves health outcomes, reduces healthcare costs, and reduces unnecessary healthcare utilization. Explores the context in which the AHC Model was implemented and the model's impacts on Medicaid, FFS Medicare, and Medicare Advantage beneficiaries. Presents information on participating organizations that had rural areas within their geographic target areas (GTAs) and compares outcomes among urban and rural participants.
Additional links: Findings at a Glance
Date: 05/2023
Sponsoring organizations: Centers for Medicare & Medicaid Services, RTI International
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Provides an overview of the Accountable Health Communities (ACH) Model, which tests whether identifying and addressing core health-related social needs (HRSNs) of community-dwelling beneficiaries improves health outcomes, reduces healthcare costs, and reduces unnecessary healthcare utilization. Explores the context in which the AHC Model was implemented and the model's impacts on Medicaid, FFS Medicare, and Medicare Advantage beneficiaries. Presents information on participating organizations that had rural areas within their geographic target areas (GTAs) and compares outcomes among urban and rural participants.
Additional links: Findings at a Glance
Date: 05/2023
Sponsoring organizations: Centers for Medicare & Medicaid Services, RTI International
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MedPAC Report to the Congress: Medicare Payment Policy, 2023
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 healthcare facilities and services; Medicare Advantage (MA), including a mandated report comparing per enrollee spending in the MA program with that of traditional fee-for-service (FFS) Medicare; and Medicare Part D.
Date: 03/2023
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 healthcare facilities and services; Medicare Advantage (MA), including a mandated report comparing per enrollee spending in the MA program with that of traditional fee-for-service (FFS) Medicare; and Medicare Part D.
Date: 03/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Enrollment Update 2022
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2012-2022.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 01/2023
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 2012-2022.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 01/2023
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature
Summarizes the results of a review of 62 studies published between January 1, 2016, and May 1, 2022, that compare Medicare Advantage and traditional Medicare across beneficiary experience, affordability, service utilization, and quality. Includes information on Medicare enrollment patterns in rural areas and identifies gaps in research on rural Medicare beneficiaries. Builds on a literature review that examined studies published between 2000 and early 2014.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek
Date: 09/2022
Sponsoring organization: KFF
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Summarizes the results of a review of 62 studies published between January 1, 2016, and May 1, 2022, that compare Medicare Advantage and traditional Medicare across beneficiary experience, affordability, service utilization, and quality. Includes information on Medicare enrollment patterns in rural areas and identifies gaps in research on rural Medicare beneficiaries. Builds on a literature review that examined studies published between 2000 and early 2014.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek
Date: 09/2022
Sponsoring organization: KFF
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Health Panel Comment Letter – Medicare Advantage Program
Offers comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information on various aspects of the Medicare Advantage (MA) program. Presents a rural perspective on the MA program and discusses health equity in the MA program, expanding access to care, and value-based contracting. Includes data on the proportion of MA plans offering supplemental benefits in noncore, micropolitan, and metropolitan counties in 2020.
Date: 08/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information on various aspects of the Medicare Advantage (MA) program. Presents a rural perspective on the MA program and discusses health equity in the MA program, expanding access to care, and value-based contracting. Includes data on the proportion of MA plans offering supplemental benefits in noncore, micropolitan, and metropolitan counties in 2020.
Date: 08/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Utilization of Z Codes for Social Determinants of Health among a Sample of Medicare Advantage Enrollees, 2017 and 2019
Examines the use of Z codes for social determinants of health in a sample of Medicare Advantage (MA) enrollees from 2016 through 2019. Identifies the five most-used Z codes among MA enrollees, including the percent of enrollees and claims with these Z codes in 2017 and 2019. Presents data on the proportion of MA enrollees with Z code claims in 2017 and 2019 across demographic characteristics, including rurality, place of service, and provider type.
Date: 04/2022
Sponsoring organization: Centers for Medicare & Medicaid Services
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Examines the use of Z codes for social determinants of health in a sample of Medicare Advantage (MA) enrollees from 2016 through 2019. Identifies the five most-used Z codes among MA enrollees, including the percent of enrollees and claims with these Z codes in 2017 and 2019. Presents data on the proportion of MA enrollees with Z code claims in 2017 and 2019 across demographic characteristics, including rurality, place of service, and provider type.
Date: 04/2022
Sponsoring organization: Centers for Medicare & Medicaid Services
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March 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2022 meeting. Covers findings from MedPAC's annual beneficiary and clinician focus groups, Medicare payment policies to support safety-net providers, opportunities to strengthen the geriatric workforce, integrating episode-based payment with population-based payment, and improving Medicare Advantage risk adjustment. Includes rural references throughout.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2022 meeting. Covers findings from MedPAC's annual beneficiary and clinician focus groups, Medicare payment policies to support safety-net providers, opportunities to strengthen the geriatric workforce, integrating episode-based payment with population-based payment, and improving Medicare Advantage risk adjustment. Includes rural references throughout.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2022
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 healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
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 healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Trends in Racial, Ethnic, Sex, and Rural-Urban Inequities in Health Care in Medicare Advantage: 2009-2018
Presents an analysis of historical trends in inequities by race and ethnicity, sex, and rural-urban residence among Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide. Uses patient experience and clinical care measures to examine how inequities in healthcare have changed between 2009 and 2018, how scores for each beneficiary group have changed over time, and which inequities remained in 2018.
Date: 12/2021
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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Presents an analysis of historical trends in inequities by race and ethnicity, sex, and rural-urban residence among Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide. Uses patient experience and clinical care measures to examine how inequities in healthcare have changed between 2009 and 2018, how scores for each beneficiary group have changed over time, and which inequities remained in 2018.
Date: 12/2021
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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Medicare Telemedicine Snapshot
Presents data on telemedicine utilization by Medicare beneficiaries from March 1, 2020 to February 28, 2021, including pre- and post-pandemic rates of accessing telehealth services, trends in e-visits and virtual check-ins, geographic breakdowns including rural and urban residence, and beneficiary characteristics. Uses data from Medicare Fee-for-Service (FFS) claims, Medicare Advantage (MA) encounters, and Medicare enrollment.
Date: 12/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Presents data on telemedicine utilization by Medicare beneficiaries from March 1, 2020 to February 28, 2021, including pre- and post-pandemic rates of accessing telehealth services, trends in e-visits and virtual check-ins, geographic breakdowns including rural and urban residence, and beneficiary characteristics. Uses data from Medicare Fee-for-Service (FFS) claims, Medicare Advantage (MA) encounters, and Medicare enrollment.
Date: 12/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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