Cost is often a significant barrier to accessing care for
the rural Medicare population, so having a better
understanding of the variations in cost-sharing at
various types of safety-net facilities is important. The
purpose of this study was to empirically investigate cost
as a barrier to accessing care at Federally Qualified
Health Centers (FQHCs) and Rural Health Clinics (RHCs)
for the rural Medicare population. In the regression
analyses, we found statistically significant variations
in cost-sharing, charge, and coinsurance per claim based
on facility type, after controlling for other factors.
Cost-sharing per claim (sum of the deductible and
coinsurance amounts) was higher at RHCs than FQHCs.
Despite the substantial set of benefits that Medicare
provides, many beneficiaries (especially those living in
rural areas) are often left vulnerable by financial
burdens and unmet needs. If populations are not able to
access care (especially primary care) due to cost, it may
lead to several negative consequences. Patients may
decide to postpone or forgo care and end up in the
emergency department – often a more costly, and
less effective, alternative.