RUPRI Center for Rural Health Policy Analysis

Products

Listed by publication date. You can also view these publications alphabetically.

For a complete list of publications from the Center, which may include older publications and publications funded by other sources, please see the Center's website.

2017

  • Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2017
    As of June 2017, the percentage of rural enrollment in Part D plans, which include stand-alone prescription drug plans (PDPs) and Medicare Advantage with Prescription Drug (MA-PD) plans, lags urban enrollment despite significant growth overall in the number of Medicare beneficiaries with prescription drug coverage through Medicare Part D plans.
  • Distribution of Disproportionate Share Hospital Payments to Rural and Critical Access Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2017
    This policy brief provides information about the potential impact of scheduled changes in Medicaid Disproportionate Share Hospital (DSH) payment on hospitals in 47 states. We expect variation across states, because of differences in state policies allocating DSH payments, as well as geographic variation by census region.
  • Rural Long-Term Services and Supports: A Primer
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2017
    This paper provides policymakers and other interested stakeholders a primer on the fundamentals of the rural LTSS system, rural access to and use of LTSS, and the opportunities and limitations of current federal and state LTSS policy for advancing rural health system transformation toward a high-performing rural health delivery system.
  • Medicare Advantage Enrollment Update 2017
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2017
    Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans and other prepaid enrollment plans. Compares national and rural MA enrollment, and variability by state.
  • Rural/Urban Analysis on Individual Insurance Market Topics
    Fact Sheet
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2017
    Some special challenges face the development and sustainability of marketplace plans in rural areas. This data release provides some additional detail on some important topics, with particular importance to rural people, places, and providers.
  • After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2017
    A new paper describing opportunities for rural communities to develop a high performance rural health system after hospital closure, including three case studies that describe real-world transitions from hospital-based locus of care to new models of care delivery in rural places.
  • Issues Confronting Rural Pharmacies after a Decade of Medicare Part D
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2017
    This brief reports on a survey of very rural independent pharmacies designed to assess threats to their sustainability. Major, immediate issues included delays in updates to maximum allowable costs (MACS), charges for remuneration fees, competition from mail order pharmacies; and, status as a “non-preferred pharmacy” for Medicare Part D plans.
  • Telepharmacy Rules and Statutes: A 50-State Survey
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2017
    This is summary analysis reviews administrative rules and legislative statutes governing the practice of telepharmacy in all 50 states. Telepharmacy is specifically authorized in 23 states and 16 states have no rules or legislation authorizing telepharmacy. Other states have pilot programs or waivers that would enable telepharmacy.
  • 2016 Rural Enrollment in Health Insurance Marketplaces, by State
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2017
    Cumulative county-level enrollment rates in Health Insurance Marketplaces (HIMs) in metropolitan and non-metropolitan areas of each state, defined as the percentage of “potential market” participants selecting plans, are presented as of March 2016. States are separated by Medicaid expansion status.
  • Changing Rural and Urban Enrollment in State Medicaid Programs
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2017
    Medicaid enrollment growth in 36 states is analyzed by rural and expansion status, pre- and post-ACA. Enrollment growth was larger in expansion states but did take place in most states, with significant state-level variation in both groups. Metropolitan areas generally had higher growth than micropolitan and rural areas.

2016

  • Medicare Accountable Care Organizations: Quality Performance by Geographic Categories
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2016
    This brief provides an analysis of the differences in ACO performance on the quality measures among the Medicare Shared Saving Program (MSSP) ACOs with varying levels of rural presence. Findings suggest that ACOs with a significant rural presence have performed as well as, if not better than, urban ACOs in delivering quality care.
  • Spread of Accountable Care Organizations in Rural America
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2016
    This policy brief updates a RUPRI Center analysis of the presence of Medicare ACO’s in rural areas of the United States in 2013. Using participation data through 2015, the current brief finds that there has been broad growth in the number of places where ACO participating providers can be found, including rural locations.
  • Medicare Advantage Enrollment Update 2016
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 09/2016
    This annual brief examines Medicare Advantage (MA) enrollment data from March 2015 and March 2016. It shows that enrollment in MA and other prepaid plans increased, both nationally and in non-metropolitan areas, but the rate of growth has slowed compared to previous years.
  • Rural Medicare Advantage Market Dynamics and Quality: Historical Context and Current Implications
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2016
    There is significant variation in the quality ratings of MA plans that are available to rural beneficiaries. This brief suggests that policy interventions may be necessary to improve the quality of MA plans in rural areas.
  • Health Insurance Marketplaces: Premium Trends in Rural Areas
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2016
    Total Health Insurance Marketplace premiums have grown disproportionately in rural places in 2016. Urban counties have an average of 4.2 firms, while rural counties average 3.2 firms offering coverage through the HIMs. This causes concern since, at the county level, we find that as the number of firms increases, premiums increase at a slower rate.
  • Medicare Accountable Care Organizations: Beneficiary Assignment Update
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2016
    This brief updates Brief No. 2014-3 and explains changes in the Centers for Medicare & Medicaid Services Accountable Care Organization regulations issued in June 2015 pertaining to beneficiary assignment for Medicare Shared Savings Program ACOs. Understanding ACO beneficiary assignment policies is dire in managing ACO providers and beneficiaries.
  • Rural Medicare Advantage Plan Payment in 2015
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2016
    Payment to Medicare Advantage (MA) plans was fundamentally altered by the Patient Protection and Affordable Care Act of 2010 (ACA). This brief finds that while plans operating in both rural and urban areas have experienced a reduction in MA payment, the reduction in rural payment overall has been less significant.

2015

  • Medicare Value-based Payment Reform: Priorities for Transforming Rural Health Systems
    Report
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2015
    As Medicare moves to value-based payment, healthcare groups are made more accountable for patient health. But the changes have been concentrated in urban areas. Policies meant to strengthen rural health systems are complicating payment and delivery system reform in rural areas. This study examines ways to include rural areas in the changes.
  • Rural Enrollment in Health Insurance Marketplaces, by State
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2015
    This brief compares cumulative enrollment totals in Health Insurance Marketplaces in metropolitan and non-metropolitan areas by state and the percentages of potential market participants enrolled. Non-metropolitan enrollment rates were higher in several states. The analysis shows how well outreach/enrollment efforts targeting rural areas work.
  • Rural Enrollment in Health Insurance Marketplaces
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2015
    This brief analyzes Health Insurance Marketplace enrollment outcomes for 2015 at rating area/county levels. Enrollment rates are reported by number of firms participating and for multiple geographic categories: population density, census region, and metropolitan status of the county. Rural/urban rates are often similar, but areas of concern exist.
  • Care Coordination in Rural Communities Supporting the High Performance Rural Health System
    Report
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2015
    This paper examines care coordination programs and processes that affect rural areas to discover what is happening in rural communities, how various programs and approaches are working, who benefits, and to make policy recommendations that will facilitate care coordination efforts in support of high performance rural health system development.
  • Characteristics of Rural Accountable Care Organizations (ACOs) - A Survey of Medicare ACOs with Rural Presence
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2015
    In this policy brief, we present the findings of a survey of 27 rural accountable care organizations, focusing on characteristics important to their formation and operation.
  • Characteristics of Rural Communities with a Sole, Independently Owned Pharmacy
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2015
    This brief describes the populations of rural communities with single independently owned pharmacies. About 2.7 million people, more than 25% of whom live below the poverty level, live in 663 rural communities with sole independently owned pharmacies. For about 70% of these rural communities, the next closest pharmacy is more than 10 miles away.
  • Health Insurance Marketplaces: Early Findings on Changes in Plan Availability and Premiums in Rural Places, 2014-2015
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2015
    Analysis of national county-level Health Insurance Marketplace (HIM) plan data for 2014 and 2015 shows there is no systematic pattern to rural experiences of HIMs, although some isolated places may be at risk for weak outcomes.
  • Hospital Views of Factors Affecting Telemedicine Use
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2015
    This brief expands upon previous research by examining hospital-based use of telemedicine by determining the type of use by hospitals, whether it be providing services as a hub or receiving services as a spoke, and then identifying factors from the hospitals’ perspectives that affect use.
  • A Rural Taxonomy of Population and Health-Resource Characteristics
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2015
    This brief reports the newly developed taxonomy of rural places based on relevant population and health-resource characteristics and discusses how this classification tool can be utilized by policymakers and rural communities.
  • Developmental Strategies and Challenges for Rural Accountable Care Organizations
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 02/2015
    This brief offers insights into the initial strategic decisions and challenges of four accountable care organizations (ACOs) with rural presences. These ACOs were formed as a step toward a value-driven rural delivery system. While several challenges need to be addressed, these insights can inform development of other rural ACOs.
  • Surgical Services in Critical Access Hospitals, 2011
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 02/2015
    This brief describes the types and volume of major surgical services provided in critical access hospitals across four regionally representative states in 2011.
  • 2014: Rural Medicare Advantage Enrollment Update
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2015
    Rural Medicare Advantage (MA) and other prepaid plan enrollment in March 2014 was about 1.95 million, an increase of more than 216,000 from March 2013. Enrollment increased to 1.99 million in October 2014. Rural and urban enrollment increased despite reductions in payment and the conclusion of the MA bonus payment demonstration at 2014’s end.

2014

  • Rural Implications of the Blueprints for State-Based Health Insurance Marketplaces
    Report
    RUPRI Center for Rural Health Policy Analysis
    Date: 09/2014
    This report presents various states’ approaches to the Health Insurance Marketplace, including service and rating areas, network adequacy requirements, rural consumer outreach, rural representation on the marketplace governing board, certification and oversight of Qualified Health Plans, and design of the Small Business Health Options Program.
  • Geographic Variation in Premiums in Health Insurance Marketplaces
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2014
    This policy brief analyzes the 2014 premiums of health insurance plans available in the new marketplaces created by the Affordable Care Act.
  • The Effect of Medicare Payment Policy Changes on Rural Primary Care Practice Revenue
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2014
    This policy brief describes the impact of recent Medicare payment updates to the Geographic Practice Cost Indices portion of the Medicare Physician Fee Schedule on rural primary care providers’ practice revenue from Medicare.
  • Facilitating the Formation of Accountable Care Organizations in Rural Areas
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2014
    This brief shows characteristics contributing to the formation of four accountable care organizations (ACOs) that serve rural Medicare beneficiaries, one each of the four census regions. The findings can help rural providers interested in forming/participating in an ACO assess the status and potential gaps of their core structures and capabilities.
  • Update: Independently Owned Pharmacy Closures in Rural America
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2014
    This brief examines the closure of independently owned rural pharmacies in the United States from 2003 to 2013 and its effects on rural Americans’ access to medications and other pharmacy services. This report is an update to past publications from RUPRI.
  • A Guide to Understanding the Variation in Premiums in Rural Health Insurance Marketplaces
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2014
    This brief provides a framework for assessing variations in the premiums of plans offered in the Health Insurance Marketplaces across geography.
  • Extent of Telehealth Use in Rural and Urban Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2014
    This brief provides discussion with statistics on the use of telehealth in rural hospitals and the opportunities telehealth can bring to supporting healthcare in rural communities.
  • Medicare Accountable Care Organizations: Program Eligibility, Beneficiary Assignment, and Quality Measures
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2014
    This brief discusses Medicare Shared Savings Program eligibility, participation requirements, and quality measures relative to accountable care organization formation.
  • The Uninsured: An Analysis by Age, Income, and Geography
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 02/2014
    This brief analyzes the rural/urban uninsured populations by age. Furthermore, we discuss the potential for age differences between rural and urban uninsured populations to drive Health Insurance Marketplace premiums upward, an effect which may be mitigated or compounded by various other factors.
  • 2012 Rural Medicare Advantage Quality Ratings and Bonus Payments
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2014
    This brief analyzes differences in rural Medicare Advantage (MA) quality ratings and payments and suggests reasons why quality ratings vary by geography. Overall, the quality rating of MA plans in rural areas is lower than in urban areas, a result of the availability of, and enrollment in, different types of MA plans.
  • Trends in Hospital Network Participation and System Affiliation, 2007-2012
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 2014
    Network participation and system affiliation are two ways for hospitals to build and/or access necessary capacities to engage in the transformation to an integrated, patient-centered, pay-for-value care delivery model. This brief tracks trends in network participation and system affiliation among U.S. general community hospitals from 2007 to 2012.

2013

2012

2011

  • Rural Medicare Advantage 2011: Enrollment Trends and Plan Characteristics
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2011
    This paper reports findings from Centers for Medicare and Medicaid Services data analysis to examine the trends/geographic variations in Medicare Advantage (MA) plan enrollment, premiums, and market concentration by firm. The data provide an overview of the MA program in rural America and highlight key rural/urban differences within the program.
  • The High Performance Rural Health Care System of the Future
    RUPRI Center for Rural Health Policy Analysis
    Date: 09/2011
    This project describes a future rural system that would be built on foundations of affordability, accessibility, community focus, high quality, and patient centeredness.
  • June 2011: Rural Medicare Advantage Enrollment Update
    RUPRI Center for Rural Health Policy Analysis
    Date: 09/2011
    This brief 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.
  • Patient-Centered Medical Home Services in 29 Rural Primary Care Practices: A Work in Progress
    RUPRI Center for Rural Health Policy Analysis
    Date: 09/2011
    This brief discusses responses from 29 rural physician practices. When asked about the use of specific policies/procedures included as criteria to certify patient-centered medical homes, fewer of them would qualify in each of five domains, including access to care, population-based, quality, care management, and clinical information management.
  • Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions in the United States, by Insurance Type, 2000 to 2004
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2011
    In this policy brief, we report findings from a study that used nationwide hospital inpatient discharge data to examine the trends and regional variations of rural hospital charges due to ambulatory care sensitive conditions in the United States, by insurance type, from 2000 to 2004.
  • Independently Owned Pharmacy Closures in Rural America, 2003-2010
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2011
    This policy brief 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.
  • March 2011: Growth in PPOs Dominates the Rural MA Market in 2011
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    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).
  • Use of Health Information Technology in Support of Patient-Centered Medical Homes Is Low Among Non-metropolitan Family Medicine Practices
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2011
    Are physician practices, especially non-metropolitan primary care practices, ready to become patient-centered medical homes? We use a nationwide survey of physician practices to partially answer this question, focusing on the use of health information technology.
  • Medicare Beneficiary Access to Primary Care Physicians -- Better in Rural, but Still Worrisome
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2011
    In this policy brief, results from a large national physician survey are used to assess U.S. primary care physician and general surgeon willingness to accept Medicare patients and physician-reported reasons for not accepting Medicare patients.

2010

2009

  • Rural Primary Care Physician Payment 2006-2009: What a Difference Three Years Doesn't Make
    RUPRI Center for Rural Health Policy Analysis
    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.
  • The Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Leake County, Mississippi
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2009
    The U.S. healthcare crisis is especially strong in rural communities. The experience of Leake County, a rural Mississippi county, embodies these problems.
  • The Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Nemaha County, Nebraska
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2009
    The U.S. healthcare crisis is especially strong in rural communities. The experience of Nemaha County, a small county located in southeastern Nebraska, illustrates the reach of these problems into counties that are somewhat stable during times of economic turbulence.
  • The Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Walthall County, Mississippi
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2009
    The U.S. healthcare crisis is especially strong in rural communities. The experience of Walthall County, a small county located in southwestern Mississippi, exemplifies these problems.
  • July 2009: Rural Enrollment in Medicare Advantage Continues to Grow
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2009
    Rural enrollment in Medicare Advantage continues to increase, with growth in the last 18 months led by the growth of preferred provider organization (PPO) plans. Despite the growth in PPO plans, private fee-for-service plans continue to dominate enrollment in rural areas and have accounted for much of the program's growth since 2005.
  • Workforce Issues Among Sole Community Pharmacies
    North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
    Date: 07/2009
    This brief explores the shared experiences of sole community pharmacist-owners regarding the challenges facing the pharmacy workforce in their communities and their concerns about their pharmacies’ futures.
  • Impact of the Recession on Rural America: Rising Unemployment Leading to More Uninsured in 2009
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2009
    This brief presents the results of state and county analysis of unemployment rates nationally in urban and rural (non-metropolitan) areas during the period 2007-February 2009 and discusses the impact of rising unemployment on uninsurance in rural areas.
  • May 2009: PPOs Driving Growth in Rural Medicare Advantage Enrollment
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2009
    Rural Medicare Advantage (MA) enrollment had rapid growth in preferred provider organization plans and a decline in the growth rate of private fee-for-service (PFFS) plans. MA enrollment has continued to climb, but it has been impacted by the slowed rate of growth in PFFS plans, which cover more than half of MA enrollees in rural areas.
  • A Rural-Urban Comparison of a Building Blocks Approach to Covering the Uninsured
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2009
    This brief uses a RUPRI health insurance model to compare the effects of a building blocks approach on health insurance coverage and health spending, focusing on the geographic differences (by metropolitan and non-metropolitan) of this approach.
  • April 2009 Rural Enrollment in Medicare Advantage: Growth in PPOs Outpacing Growth in PFFS
    RUPRI Center for Rural Health Policy Analysis
    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.
  • Loss of Community Pharmacies Since 2006: State Experiences
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2009
    This brief presents the latest data from a continuous monitoring of the status of rural pharmacies by the RUPRI Center. The brief includes a table showing the data by state.
  • Rural Enrollment in Medicare Advantage: Growth Slows in 2008
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 03/2009
    The rate of growth of enrollment in the Medicare Advantage program decreased significantly in 2008, compared to previous years. The growth rate in preferred provider organization plans in rural areas now exceeds that in private fee-for-service plans. This updates earlier findings from analysis of the MA program reported by the RUPRI Center.

2008

2007

2006

  • The Experience of Sole Community Rural Independent Pharmacies with Medicare Part D: Reports from the Field
    North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
    Date: 11/2006
    This case study describes firsthand reports from 12 rural independent pharmacists in seven states about their experiences with Medicare Part D plans in the first seven months of 2006.
  • Medicare Physician Payment: Impacts of Changes on Rural Physicians
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 09/2006
    This policy brief provides an overview of the effects of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 on physician payment rates in rural areas. The brief discusses the effects of the Medicare incentive payment for providing services in shortage areas and of the bonus for practicing in a physician scarcity area.
  • Elements of Successful Rural Diabetes Management Programs
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2006
    This report shares findings from a study about local innovations implemented by rural chronic disease management programs. Using diabetes as a proxy for all chronic diseases, the authors explored how local innovations overcame challenges of the rural setting to provide effective and efficient disease management.
  • Chronic Disease Management Systems (Registries) in Rural Health Care
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2006
    A Chronic Disease Management System (CDMS) is a tool that helps providers collect and analyze patient information to promote quality care. This study shows that CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology.
  • Medicare Part D: Early Findings on Enrollment and Choices for Rural Beneficiaries
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2006
    This policy brief provides a first snapshot of enrollment in Medicare Part D in rural and urban areas across the United States and outlines the early findings from an analysis of plans available to rural persons under this program.

2005

2004

2003

  • Care Across the Continuum: Access to Health Care Services in Rural America
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2003
    This paper proposes that a continuum of care serve as the framework with which to consider rural healthcare policies, focusing on people and on places where people live rather than on the wants of providers and constituencies.
  • Availability and Use of Health Plan Choices in Rural America: Medicare+Choice, Commercial HMO, and Federal Employees Health Benefit Program Plans
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2003
    This report discusses the availability of Medicare + Choice (M+C), commercial HMO, and Federal Employee Health Benefit Program insurance plans and the potential impact of M+C service delivery area changes on healthcare access in rural areas.
  • Medicare Physician Payment: Practice Expense
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2003
    This rural policy brief examines the physician practice expense component of Medicare payment, which proportionately results in greater geographic physician payment variation than does the physician work payment. The practice expense adjustment warrants careful validation to demonstrate that the index measures actual geographic cost differences.
  • Medicare Issues
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2003
    This document provides an overview of rural policy issues related to Medicare. The presentation was made August 26, 2003 in Casper, Wyoming.
  • Enrollment in FEHBP Plans In Rural America: What Are The Implications For Medicare Reform?
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2003
    This brief presents information showing how the Federal Employees Health Benefits Program is functioning in rural areas. Enrollment patterns into the various options available in the FEHBP, descriptions of choices typically available in rural areas, and location of primary care providers used by plans in a sample of rural communities is presented.
  • Enrollment in FEHBP Plans in Rural Areas
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2003
    This study of health plan enrollment decisions made by rural retirees and federal workers examines how a Federal Employees Health Benefit Program plan may work when applied to Medicare.
  • Enrollment in the Federal Employees Health Benefit Program (FEHBP): State and County-Level Enrollment Analysis
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2003
    This analysis details information on Federal Employees Health Benefit Program (FEHBP) enrollment in rural counties, including the number of health insurance plans available and number of enrollees. FEHBP is being considered as a model for involving private insurers in Medicare.
  • Rural Hospital HIPAA Readiness and Resource Needs
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2003
    This rural policy brief presents a survey of rural hospitals regarding the extent of their preparation for HIPAA requirements and their need for resources to implement them.
  • Analysis of Availability of Medicare+Choice, Commercial HMO, and FEHBP Plans in Rural Areas: Implications for Medicare Reform
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 03/2003
    This rural policy brief examines the viability of introducing private competition into the Medicare program. It discusses the availability of Medicare+Choice1, commercial HMO, and Federal Employees Health Benefits Program plans in rural (nonmetropolitan) counties.
  • Assessment of Proposals for a Medicare Outpatient Prescription Drug Benefit: The Rural Perspective
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2003
    This policy paper assesses legislative proposals to add an outpatient prescription drug benefit to the Medicare program and their implications for the delivery of services and the welfare of beneficiaries in rural areas.
  • Medicare Physician Payment
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2003
    This rural policy brief examines how the Resource-Based Relative Value Scale has replaced the 25-year-old Medicare CPR charge system.

2002

2001

2000