Research Alert: November 14, 2022

Patterns of Health Care Use among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+.

Key Findings

• As baby-boomers age and become eligible for Medicare, the percentage of the Medicare population age 85+ has been declining in both rural and urban areas, ranging from 15% in 2011 to 12% in 2017.
• The percentage of the age 85+ population living in the community (versus facilities) did not differ by rural and urban residence and increased from 85% to 88% over the 2010-2017 study period.
• Among community-dwelling beneficiaries age 85+, over years 2010-2017, enrollment in fee-for-service (FFS) Medicare has steadily declined from 84% to 74% in rural areas and from 70% to 60% in urban areas, while enrollment in Medicare Advantage plans increased.
• Among Medicare FFS community-dwelling beneficiaries age 85+:
  • The rate (percentage) and frequency with which rural and urban FFS beneficiaries were visiting primary care providers (PCPs) was similar over most years.
  • Rural FFS beneficiaries were using proportionately more outpatient services (excluding visits to PCPs) than urban FFS beneficiaries, but significantly fewer specialized and dental services.
  • While the percent of urban FFS beneficiaries using the emergency department (ED) was near 30% in most years, rural FFS beneficiaries' use of the ED increased from 27% to 43% in 2010-2017.

Additional Resources of Interest:

• More information about the Maine Rural Health Research Center
• More information from the Rural Health Information Hub's topic guide: Healthcare Access