Assessing Rural Implications of Changes in Insurance Markets
A multi-methods approach will be used in this project to explore aspects of insurance market changes in rural areas. Using a qualitative research approach, we will analyze state HIE plans and, where possible, activities of exchanges. This analysis will continue Center work that summarizes state activities using the rural considerations matrix described in a January 2012 Center paper through the collection and monitoring of state work on HIEs.
The Center will complement this work with quantitative analysis that describe rural insurance markets, drawing on several national-level datasets in order to determine what policy variables can potentially affect the level of market competition in a geographic area. The analysis will be used to develop a comprehensive picture of the current structure of insurance markets in rural areas using descriptive and multivariate models as well as to develop simulation models that can be used to analyze the policy options currently under consideration (e.g., the ACA and state-level HIEs).
Hypotheses: The qualitative analysis will generate descriptions of state plans, establishing ranges of decisions along continua for each of the rural considerations. For example, the plans for navigators could range from single source contracting to accepting all bids. The implications for rural people will be considered in the context of the characterization of final decisions made in the plans.
The quantitative research will focus on the firm's decisions to enter and offer insurance plans in a particular geographic market, expected to be driven by three conditions:
- Demand for insurance, which would change with expansions in coverage and enrollment through HIEs,
- Market characteristics, as evident in the number of insurance plans currently offered, and
- The availability of providers to form networks, crucial to the continued development of insurance markets.
Accountable Care Organizations in Rural America
RUPRI Center for Rural Health Policy Analysis
This policy brief reports that Medicare Accountable Care Organizations currently operate in 16.7% of all U.S. non-metropolitan counties.