Rural policy brief最新文献

Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics. 比较城乡医保优势受益人特征。

Rural policy brief Pub Date : 2019-03-01

Abigail Barker, Lindsey Nienstedt, Leah Kemper, Timothy McBride, Keith Mueller

{"title":"Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics.","authors":"Abigail Barker, Lindsey Nienstedt, Leah Kemper, Timothy McBride, Keith Mueller","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: The Medicare Advantage (MA) program allows Medicare beneficiaries to receive benefits from private plans rather than from traditional fee-for-service (FFS) Medicare. Little is known about the rural and urban differences in the populations that enroll in the MA program, and these differences may be important for setting policy. This brief uses data from the 2012-13 Medicare Current Beneficiary Survey (MCBS) to describe these differences, and combined with county-level data on MA issuer participation, this dataset also allows us to assess the degree to which issuers may engage in selective MA market entry on the basis of demographic characteristics.Key findings: (1) Rural and urban MA and FFS populations did not differ much on average by any characteristics reported in the data, including age, self-reported health status, cancer diagnosis, smoking status, Medicaid status, or by other variables assessing frailty and presence of chronic conditions. (2) Most measures of access were similar across rural and urban respondents. However, in terms of cost, urban enrollees were less likely to pay an additional premium (beyond Medicare Part A and B) to obtain MA coverage: 42 percent reported doing so in urban places, while 54 percent did so in rural places. (3) While rurality on its own was often a significant predictor of lower issuer participation in a county’s MA market, the addition of other demographic characteristics did not influence the prediction. In other words, we found no evidence, based upon MCBS data, that issuers exclude rural counties due to other demographics.","PeriodicalId":38994,"journal":{"name":"Rural policy brief","volume":"2019 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37163272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018. 《与小农村实践相关的绩效激励支付制度的变化》，2018年。

Rural policy brief Pub Date : 2018-11-01

Abiodun Salako, A Clinton MacKinney, Fred Ullrich, Keith Mueller

引用次数: 0

Trends in Hospital System Affiliation, 2007-2016. 2007-2016年医院系统关联趋势

Rural policy brief Pub Date : 2018-10-01

Onyinye Oyeka, Fred Ullrich, Keith Mueller

引用次数: 0

Spread of Medicare Accountable Care Organizations in Rural America. 医疗保险责任医疗机构在美国农村的推广。

Rural policy brief Pub Date : 2018-08-01

Nora Kopping, Fred Ullrich, Keith Mueller

引用次数: 0

Health Insurance Marketplaces: Issuer Participation and Premium Trends in Rural Places, 2018. 健康保险市场:农村地区发行人参与和保费趋势，2018。

Rural policy brief Pub Date : 2018-08-01

Abigail R Barker, Lindsey Nienstedt, Leah M Kemper, Timothy D McBride, Keith J Mueller

{"title":"Health Insurance Marketplaces: Issuer Participation and Premium Trends in Rural Places, 2018.","authors":"Abigail R Barker, Lindsey Nienstedt, Leah M Kemper, Timothy D McBride, Keith J Mueller","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: Since 2014, when the Health Insurance Marketplaces (HIMs) authorized by the Patient Protection and Affordable Care Act (PPACA) were implemented, considerable premium changes have been observed in the marketplaces across the 50 states and the District of Columbia. This policy brief assesses the changes in average HIM plan premiums from 2014 to 2018, before accounting for subsidies, with an emphasis on the widening variation across rural and urban places, providing information during Congressional debates on the future of the program.Key findings: (1) Insurance issuers reduced HIM participation across both rural and urban places (with 1.7 and 2.2 issuers, respectively), both in states that expanded Medicaid under the PPACA and in non-expansion states. (2) The average adjusted premium (before premium subsidy) continues to rise across all of the above categories, and the gap has widened between the 32 Medicaid expansion and 19 non-expansion states. Average premiums in rural counties are higher than average premiums in urban counties in both expansion and non-expansion states (by $43 per month and $27 per month, respectively). (3) Prior trends of lower premium changes at greater population densities are no longer observed in the 2018 data. (4) In 2018, 1,581 counties (52 perent) have one participating insurance issuer. Nationwide, 42 percent of all urban counties and 55 percent of all rural counties only have one issuer.","PeriodicalId":38994,"journal":{"name":"Rural policy brief","volume":"2018 3","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36489220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Update: Independently Owned Pharmacy Closures in Rural America, 2003-2018. 更新:2003-2018年美国农村独立药店关闭。

Rural policy brief Pub Date : 2018-07-01

Abiodun Salako, Fred Ullrich, Keith J Mueller

引用次数: 0

Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update. 城乡D部分处方药计划参保情况:2017年6月更新。

Rural policy brief Pub Date : 2017-12-01

Paula Weigel, Fred Ullrich, Keith Mueller

引用次数: 0

Distribution of Disproportionate Share Hospital Payments to Rural and Critical Access Hospitals. 分配不成比例的医院费用给农村医院和关键医院。

Rural policy brief Pub Date : 2017-11-01

Erin M Mobley, Fred Ullrich, Keith J Mueller

引用次数: 0

Medicare Advantage Enrollment Update 2017. 2017年医疗保险优惠登记更新。

Rural policy brief Pub Date : 2017-08-01

Fred Ullrich, Keith Mueller

{"title":"Medicare Advantage Enrollment Update 2017.","authors":"Fred Ullrich, Keith Mueller","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: The RUPRI Center for Rural Health Policy Analysis reports annually on rural beneficiary enrollment in Medicare Advantage (MA) plans, noting any trends or new developments evident in the data. These reports are based on data through March of each year, capturing results of open enrollment periods.Key findings: (1) Nationally, 1 in 3 Medicare beneficiaries is enrolled in an MA plan. In non-metropolitan areas, nearly 1 in 4 (23.5 percent) beneficiaries is enrolled in an MA plan. (2) Enrollment in MA plans, measured either as an overall count or as a proportion of eligible Medicare beneficiaries, has increased in both metropolitan and non-metropolitan populations since 2004. (3) Between 2015 and 2017, the proportion of non-metropolitan Medicare-eligible beneficiaries enrolled in local preferred provider organization (PPO), regional PPO, and \"other\" plans (including cost, health care pre-payment [HCPP], medical savings account [MSA] and demonstration plans) remained relatively steady. During the same period, the proportion of Medicare-eligible beneficiaries enrolled in health maintenance organization (HMO) plans increased slightly (from 28.5 percent in 2015 to 29.8 percent in 2017) while the proportion enrolled in private fee-for-service (PFFS) plans decreased slightly (from 5.6 percent in 2015 to 3.8 percent in 2017).","PeriodicalId":38994,"journal":{"name":"Rural policy brief","volume":"2017 5","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36036995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Issues Confronting Rural Pharmacies after a Decade of Medicare Part D. 医疗保险D部分实施十年后农村药房面临的问题。

Rural policy brief Pub Date : 2017-04-01

Fred Ullrich, Abiodun Salako, Keith Mueller

{"title":"Issues Confronting Rural Pharmacies after a Decade of Medicare Part D.","authors":"Fred Ullrich, Abiodun Salako, Keith Mueller","doi":"","DOIUrl":"","url":null,"abstract":"Purpose. The RUPRI Center for Rural Health Policy Analysis has been monitoring the status of rural independent pharmacies since the implementation of Medicare Part D in 2005. After a decade of Part D, we reassess in this brief the issues that concern rural pharmacies and may ultimately challenge their provision of services. This reassessment is based on survey responses from rural pharmacists. Key Findings: (1) Rural pharmacists indicated that two challenges--direct and indirect remuneration (DIR) fees, and delayed maximum allowable cost (MAC) adjustment--ranked highest on scales of both magnitude and immediacy. Nearly eighty (79.8) percent of respondents reported DIR fees as a very large magnitude challenge, with 83.3 percent reporting this as a very immediate challenge. Seventy-eight percent of respondents reported MACs not being updated quickly enough to reflect changes in wholesale drug costs as a very large magnitude challenge, with 79.7 percent indicating it as a very immediate challenge. (2) Medicare Part D continues to be a concern for rural pharmacies--58.8 percent of pharmacists said being an out-of-network pharmacy for Part D plans was a very large magnitude challenge (an additional 29.0 percent said large magnitude) and 60.5 percent said it was a very immediate challenge (an additional 28.1 percent said moderately immediate). (3) Pharmacy staffing, competition from pharmacy chains, and contracts for services for Medicaid patients were less likely to be reported as significant or immediate challenges.","PeriodicalId":38994,"journal":{"name":"Rural policy brief","volume":" 2017 3","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34929743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0