Medicare

Current Projects

Analysis of the Effects of Federal Debt Reduction and Long Term Budget Adjustment on Rural Health Care Delivery
Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Health services, Medicaid and S-CHIP, Medicare
The RUPRI Center for Rural Health Policy Analysis will examine suggested changes in Medicare and Medicaid as stated in proposals to reduce spending as part of achieving deficit reduction.

Assessing the Community Impact of the MMA
Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Legislation and regulation, Medicare, Medicare Part D
This project will measure the community-level impacts of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and will provide feedback to policymakers regarding the impact of the MMA on its policy targets (providers and beneficiaries), in the context of rural places.

Community and Financial Experience of Medicare Dependent Hospitals in Comparison to Other Rural Hospitals
Research center : North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)
This research will investigate the community and financial experience of Medicare Dependent Hospitals in comparison with other rural hospitals. Analysis of the financial experience will include comparison of the long-term profitability of MDHs to other rural hospitals, estimation of the potential profitability consequences of eliminating the payment classification, and estimation of the potential consequences of maintaining the payment classification but failing to update the base year from which costs are trended forward.

Comprehensive Study of Swing Bed Use in Rural Hospitals
Research center : North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)
This project will comprehensively address questions about how swing beds are used by rural hospitals. Questions to be answered include whether decision about use are driven by patient need, community resources, hospital operational concerns or some combination of these factors; the cost implications of swing bed use in critical access hospitals to the Medicare program; and whether patients served in swing beds differ in meaningful ways from those in skilled nursing facilities.

Dialysis Availability in Rural America
Research center : South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Medicare
Working from Medicare Dialysis Compare files and the Standard Analysis File of the US Renal Data System, we will evaluate the current availability of dialysis services across rural America. We will examine general availability of services, service to population ratios, and patient outcome measures across levels of rurality.

Effect of Type and Timeliness of Post-Acute Care on Preventable Hospital Readmissions for Rural Medicare Beneficiaries
Research center : Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Medicare
The purpose of this project is to: 1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; 2) assess how the use of swing beds affects rural patients' readmissions; and 3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients.

Impact of Changing Medicare Advantage Landscape on Rural Enrollees
Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Medicare, Medicare Advantage (MA)
This project will explore three important questions related to Medicare Advantage (MA) plans. What is the impact of recent changes in the MA market on rural Medicare beneficiaries, providers and communities? In particular, how have recent changes in markets and payment policy led to changes in the choices of plans facing beneficiaries, and the quality of those plans (as defined by the coverage offered by the plans)? Finally, what is the likely impact of changes made in Medicare Advantage payment rates passed in the Patient Protection Affordable Care Act of 2010 (PPACA) on rural enrollment in MA plans in 2011 and beyond?

Impact of Payment Policy on Access to Physician Care in Rural America
Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Medicare, Physicians
Profiles of physician practices will be constructed that specify the percent of payments derived from specific current procedural terminology (CPT) codes, dichotomized into evaluation and management (often considered to define primary care) or procedural. Differences across rural practices and between rural and urban practices will be analyzed, with implications for payment policies intended to reward rural primary care.

Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services
Research center : South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Home health, Medicare
This study will assess whether Medicare beneficiaries in rural areas receive a lower intensity of home health (HH) services compared to their urban counterparts. Specifically, the study will examine (1) the distribution of levels of HH services for four conditions: joint (hip and knee) replacement, stroke, end-stage renal disease (ESRD), and diabetes; (2) the distribution of type of provider for each condition across the levels of rurality; and (3) the median charge and payment per beneficiary for these services across the levels of rurality.

Medicare Advantage and Medicare Prescription Drug Plans in Rural Areas
Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Medicare, Medicare Advantage (MA)
The rapid growth in Medicare Advantage (MA) plans, as well as evidence that MA plans are being paid significantly more than traditional fee-for-service Medicare, has created the impetus for reform of the MA program, especially reductions in payment to MA plans. This project will continue the RUPRI Center's work in tracking and analyzing the trends in MA plan enrollment in rural areas, including changes in types of plans.

Out-of-Pocket Costs Among Rural Medicare Beneficiaries
Research center : Maine Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Disabilities, Health policy, Medicare
The purpose of this project is to examine out-of-pocket spending among Medicare beneficiaries, to identify whether there are rural-urban differences in out-of-pocket costs, and to explore what factors account for these differences. Should Medicare redesign occur, this study will provide important information against which to assess the possible impact of different design options on rural Medicare beneficiaries.

Post-Hospital Transitions in Care Among Dually-Eligible Medicare Beneficiaries
Research center : South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Hospitals and clinics, Medicare
This project will examine the hospitalization rates, post-discharge physician follow-up, and subsequent readmission rates among Medicare beneficiaries who are also enrolled in Medicaid. We will examine these dual-eligible beneficiaries by level of rurality to determine if residence is a significant factor in these rates. We will also control for co-morbidities, county characteristics, and other factors related to readmission rates.

Rural and Urban Differences in Case-Mix Among Recipients of Home Health Care
Research center : South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health disparities, Home health, Medicare
We will examine current patient case-mix for the Medicare population receiving skilled health care from a home health agency to determine if there are rural or race/ethnicity-based disparities with regards to receipt of services and clinical acuity indicators.

Use of Rural Health Clinics by Medicare Beneficiaries
Research center : North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Medicare, Rural Health Clinics (RHCs)
Determination of Medicare beneficiaries’ utilization of available RHCs and development of a descriptive profile of Medicare beneficiaries who utilize RHCs including both geographic and diagnostic elements and a comparison to Medicare beneficiaries who utilize FQHCs.

Topics Centers Researchers Other Resources Search		Medicare Current Projects Analysis of the Effects of Federal Debt Reduction and Long Term Budget Adjustment on Rural Health Care Delivery Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Health policy, Health services, Medicaid and S-CHIP, Medicare The RUPRI Center for Rural Health Policy Analysis will examine suggested changes in Medicare and Medicaid as stated in proposals to reduce spending as part of achieving deficit reduction. Assessing the Community Impact of the MMA Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Health policy, Legislation and regulation, Medicare, Medicare Part D This project will measure the community-level impacts of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and will provide feedback to policymakers regarding the impact of the MMA on its policy targets (providers and beneficiaries), in the context of rural places. Community and Financial Experience of Medicare Dependent Hospitals in Comparison to Other Rural Hospitals Research center : North Carolina Rural Health Research and Policy Analysis Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS) This research will investigate the community and financial experience of Medicare Dependent Hospitals in comparison with other rural hospitals. Analysis of the financial experience will include comparison of the long-term profitability of MDHs to other rural hospitals, estimation of the potential profitability consequences of eliminating the payment classification, and estimation of the potential consequences of maintaining the payment classification but failing to update the base year from which costs are trended forward. Comprehensive Study of Swing Bed Use in Rural Hospitals Research center : North Carolina Rural Health Research and Policy Analysis Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS) This project will comprehensively address questions about how swing beds are used by rural hospitals. Questions to be answered include whether decision about use are driven by patient need, community resources, hospital operational concerns or some combination of these factors; the cost implications of swing bed use in critical access hospitals to the Medicare program; and whether patients served in swing beds differ in meaningful ways from those in skilled nursing facilities. Dialysis Availability in Rural America Research center : South Carolina Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Chronic diseases and conditions, Medicare Working from Medicare Dialysis Compare files and the Standard Analysis File of the US Renal Data System, we will evaluate the current availability of dialysis services across rural America. We will examine general availability of services, service to population ratios, and patient outcome measures across levels of rurality. Effect of Type and Timeliness of Post-Acute Care on Preventable Hospital Readmissions for Rural Medicare Beneficiaries Research center : Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Medicare The purpose of this project is to: 1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; 2) assess how the use of swing beds affects rural patients' readmissions; and 3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients. Impact of Changing Medicare Advantage Landscape on Rural Enrollees Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Medicare, Medicare Advantage (MA) This project will explore three important questions related to Medicare Advantage (MA) plans. What is the impact of recent changes in the MA market on rural Medicare beneficiaries, providers and communities? In particular, how have recent changes in markets and payment policy led to changes in the choices of plans facing beneficiaries, and the quality of those plans (as defined by the coverage offered by the plans)? Finally, what is the likely impact of changes made in Medicare Advantage payment rates passed in the Patient Protection Affordable Care Act of 2010 (PPACA) on rural enrollment in MA plans in 2011 and beyond? Impact of Payment Policy on Access to Physician Care in Rural America Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Medicare, Physicians Profiles of physician practices will be constructed that specify the percent of payments derived from specific current procedural terminology (CPT) codes, dichotomized into evaluation and management (often considered to define primary care) or procedural. Differences across rural practices and between rural and urban practices will be analyzed, with implications for payment policies intended to reward rural primary care. Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services Research center : South Carolina Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Chronic diseases and conditions, Home health, Medicare This study will assess whether Medicare beneficiaries in rural areas receive a lower intensity of home health (HH) services compared to their urban counterparts. Specifically, the study will examine (1) the distribution of levels of HH services for four conditions: joint (hip and knee) replacement, stroke, end-stage renal disease (ESRD), and diabetes; (2) the distribution of type of provider for each condition across the levels of rurality; and (3) the median charge and payment per beneficiary for these services across the levels of rurality. Medicare Advantage and Medicare Prescription Drug Plans in Rural Areas Research center : Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Medicare, Medicare Advantage (MA) The rapid growth in Medicare Advantage (MA) plans, as well as evidence that MA plans are being paid significantly more than traditional fee-for-service Medicare, has created the impetus for reform of the MA program, especially reductions in payment to MA plans. This project will continue the RUPRI Center's work in tracking and analyzing the trends in MA plan enrollment in rural areas, including changes in types of plans. Out-of-Pocket Costs Among Rural Medicare Beneficiaries Research center : Maine Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Disabilities, Health policy, Medicare The purpose of this project is to examine out-of-pocket spending among Medicare beneficiaries, to identify whether there are rural-urban differences in out-of-pocket costs, and to explore what factors account for these differences. Should Medicare redesign occur, this study will provide important information against which to assess the possible impact of different design options on rural Medicare beneficiaries. Post-Hospital Transitions in Care Among Dually-Eligible Medicare Beneficiaries Research center : South Carolina Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Health policy, Hospitals and clinics, Medicare This project will examine the hospitalization rates, post-discharge physician follow-up, and subsequent readmission rates among Medicare beneficiaries who are also enrolled in Medicaid. We will examine these dual-eligible beneficiaries by level of rurality to determine if residence is a significant factor in these rates. We will also control for co-morbidities, county characteristics, and other factors related to readmission rates. Rural and Urban Differences in Case-Mix Among Recipients of Home Health Care Research center : South Carolina Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Health disparities, Home health, Medicare We will examine current patient case-mix for the Medicare population receiving skilled health care from a home health agency to determine if there are rural or race/ethnicity-based disparities with regards to receipt of services and clinical acuity indicators. Use of Rural Health Clinics by Medicare Beneficiaries Research center : North Carolina Rural Health Research and Policy Analysis Center Funder: Office of Rural Health Policy (ORHP) Topics: Medicare, Rural Health Clinics (RHCs) Determination of Medicare beneficiaries’ utilization of available RHCs and development of a descriptive profile of Medicare beneficiaries who utilize RHCs including both geographic and diagnostic elements and a comparison to Medicare beneficiaries who utilize FQHCs. Related Topics These related topics also list current projects: Medicare Advantage (MA) (3 items) Medicare Part D (2 items) Medicare Prospective Payment System (PPS) (2 items)

Medicare

Current Projects

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