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Rapid and Flexible Analysis of Data from Centers for Medicare and Medicaid Services
This project provides rapid and flexible analysis of CMS data in response to requests from the federal Office of Rural Health Policy (ORHP) staff, which often requires information that is only available through analysis of databases maintained by CMS. To fully supply information needed to support rural health policy development and evaluation, these databases need to be transformed into analysis files and linked to geographic identifiers and demographic characteristics, requiring data storage capacity, statistical and GIS software, demographic data files and computer programming expertise. This project will make use of secondary data files archived at the University of North Carolina Rural Health Research & Policy Analysis Center, including datasets on Medicare provider costs and revenues, health professional supply, healthcare organizations and population characteristics. Work will be ongoing.
Publications
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April 2009 Rural Enrollment in Medicare Advantage: Growth in PPOs Outpacing Growth in PFFS
Author(s): Leah Kemper, Timothy D. McBride, Keith Mueller
Report Number: 2009-4
Date: 05 / 2009
Private fee-for-service (PFFS) plans dominate enrollment in rural areas and have accounted for much of the program's expansion since 2005. However, from December 2008 through April 2009 enrollment growth of preferred provider organization (PPO) plans, both nationally and in rural areas, was double the enrollment growth of PFFS plans.
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December 2009: Rural Medicare Advantage Enrollment Grows 15% in 2009
Author(s): Leah Kemper, Timothy D. McBride, Keith Mueller
Report Number: 2010-1
Date: 01 / 2010
Rural enrollment in Medicare Advantage (MA) and other prepaid plans grew by 15% from December 2008 to December 2009, faster than the 10% national growth rate. Preferred provider organization plans drove the increased enrollment in MA plans in rural areas in 2009, while private fee-for-service (PFFS) plans continued to dominate the market with over 50% of enrollment. This landscape could change in 2010 as rural Medicare beneficiaries will experience a decline in PFFS availability, as some insurers have announced plans to pull their PFFS plans from the market.
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Experience of Rural Independent Pharmacies With Medicare Part D: Reports From the Field
Author(s): Andrea Radford, Rebecca Slifkin, Roslyn Fraser, Michelle Mason, Keith Mueller
Citation: Journal of Rural Health, 23(4), 286–293
Date: 2007
Describes first-hand reports from rural pharmacist-owners about their experiences with Medicare Part D plans in the first 7 months of 2006 in order to gain a more thorough understanding of the challenges faced by rural independent pharmacies as a result of program implementation.
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Increases in Primary Care Physician Income due to the Patient Protection and Affordable Care Act of 2010--Continued Tweaking of Physician Payment
Author(s): A. Clinton MacKinney
Report Number: 2010-2
Date: 08 / 2010
The Patient Protection and Affordable Care Act (ACA) authorizes several changes to the Resource-Based Relative Value Scale (RBRVS) system that are designed to increase primary care physician personal income and reduce geographic variation in primary care payment. In this brief, the ACA-authorized primary care payment adjustments are modeled in a prototypical rural primary care practice to assess both the potential impact on physician personal income and the likelihood that the changes will achieve the desired policy outcome.
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Independently Owned Pharmacy Closures in Rural America, 2003-2010
Author(s): Kaitlin Boyle, Fred Ullrich, Keith Mueller
Date: 06 / 2011
Provides information about the closure of rural independently owned pharmacies, including pharmacies that are the sole source of access to local pharmacy services, from 2003 through 2010.
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June 2011: Rural Medicare Advantage Enrollment Update
Author(s): Leah Kemper, Lisa Pollack, Abigail Barker, Timothy D. McBride, Keith J. Mueller
Date: 09 / 2011
Shows increases in enrollment into Medicare Advantage plans in rural America. The enrollment is concentrated in plans offered by three firms, especially in the types of plans with high rural enrollment which are preferred provider organizations and private fee-for-service plans.
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Loss of Community Pharmacies Since 2006: State Experiences
Author(s): Liyan Xu, Fred Ullrich, Keith Mueller
Report Number: 2009-3
Date: 04 / 2009
This brief presents the latest data from a continuous monitoring of the status of rural pharmacies by the RUPRI Center. Local rural pharmacies continue to serve many of the nation's communities as the sole provider of pharmacy services. However, between May 2006 and December 2008, the number of retail pharmacies in 213 rural places dropped from one to zero, and the number of retail pharmacies in 118 rural places dropped from more than one to only one. The brief includes a table showing the data by state.
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March 2011: Growth in PPOs Dominates the Rural MA Market in 2011
Author(s): Leah Kemper, Lisa Pollack, Timothy D. McBride, Keith Mueller
Report Number: Brief No. 2011-3
Date: 04 / 2011
From March 2010 to March 2011, rural Medicare Advantage (MA) enrollment in preferred provider organization plans grew from 28% (396,006 enrollees) to 46% (702,315 enrollees) of total enrollment, while rural MA enrollment in private-fee-for-service plans fell from 38% (530,678 enrollees) to 16% (249,499 enrollees).
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May 2009: PPOs Driving Growth in Rural Medicare Advantage Enrollment
Author(s): Leah Kemper, Timothy D. McBride, Keith Mueller
Report Number: 2009-7
Date: 06 / 2009
A changing landscape is emerging for rural Medicare Advantage (MA) enrollment in 2009 as rapid growth in preferred provider organization (PPO) plan enrollment is coupled with a decline in the growth rate of enrollment in private fee-for-service (PFFS) plans. Enrollment in MA plans has continued to climb in 2009, but it has been impacted by the slowed rate of growth in PFFS plans, which cover over half of MA enrollees in rural areas. The growth in PPO enrollment in recent months is likely tied to changes in policy that have encouraged the growth of new PPO plans, enrollment in existing PPO plans, and expansions of the service areas of existing plans.
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Rural Enrollment in Medicare Advantage: Growth Slows in 2008
Author(s): Leah Kemper, Timothy D. McBride, Keith Mueller
Report Number: 2009-1
Date: 03 / 2009
The rate of growth of enrollment in the Medicare Advantage program decreased significantly in 2008, compared to previous years. In addition, the growth rate in preferred provider organization plans in rural areas now exceeds that in private fee-for-service plans. This policy brief updates earlier findings from analysis of the MA program reported by the RUPRI Center.
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Rural Health Snapshot 2010
Date: 08 / 2010
The Rural Health Snapshot displays selected indicators of access to health care, health behavior/risk factors, and mortality rates, comparing rural to urban residents.
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Rural Medicare Advantage 2011: Enrollment Trends and Plan Characteristics
Author(s): Leah Kemper, Lisa Pollack, Abigail Barker, Timothy D. McBride, Keith J. Mueller
Date: 10 / 2011
This paper report findings from analysis of the Centers for Medicare and Medicaid Services data to examine the trends and geographic variations in Medicare Advantage (MA) plan enrollment, premiums and market concentration by firm. MA enrollment in rural areas remains strong and continues to grow in 2011, despite the recent shift in enrollment from private fee-for-service plans to preferred provider organization plans. The data presented in this policy brief provide an overview of the Medicare Advantage program in rural America and highlight key rural/urban differences within the program.
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Rural Medicare Advantage: Modest Enrollment Growth in 2010
Author(s): Leah Kemper, Timothy D. McBride, Keith Mueller
Date: 08 / 2010
Despite a slight drop in enrollment and a dramatic shift in the landscape of the rural Medicare Advantage (MA) market in early 2010, MA plans have experienced modest growth in enrollment in rural areas over the last two quarters of 2010. The majority of the growth is concentrated in preferred provider organization plans, counteracting a decline in private fee-for-service plan enrollment.
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Rural Primary Care Physician Payment 2006-2009: What a Difference Three Years Doesn't Make
Author(s): A. Clinton MacKinney, Keith J. Mueller, Mary Charlton
Report Number: 2009-12
Date: 11 / 2009
The analysis in this brief shows the impact of Medicare's Evaluation and Management (E&M) service valuation adjustment (implemented January 1, 2007) on two prototypical primary care practices--one providing only E&M services and the other providing a mix of procedures and E&M services.
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September 2010: Rural Medicare Advantage Enrollment Update
Author(s): Leah Kemper, Lisa Pollack, Timothy D. McBride, Keith Mueller
Report Number: No. 2010-6
Date: 11 / 2010
Rural enrollment in Medicare Advantage (MA) plans grew to nearly 1.5 million enrollees in September 2010 (15% of eligible Medicare beneficiaries), while national MA enrollment grew to over 11.5 million (25%). Rural Medicare beneficiaries will find fewer options for MA health insurance coverage in 2011- an average of 16 MA plans to choose from, compared with 24 plans on average in 2010.
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