Rural/Urban Disparities in Utilization of Medical Nutrition Therapy to the Fee-for-Service Medicare Population


In order to guide effective dietary changes, patients with certain conditions can be provided Medical Nutrition Therapy (MNT). Despite the effectiveness of MNT, comparatively low utilization rates have been observed in populations with certain conditions, and socioeconomic and gender differences in utilization and compliance with MNT-recommended regimens have been observed. The objective of this study was to examine the utilization of MNT services in rural versus urban communities.

We used 2012-2016 Medicare provider data, Healthcare Common Procedure Coding System codes, and Current Procedural Terminology codes to determine the number of hours of MNT services provided, the number of healthcare providers administering the service, and the number of beneficiaries served by each provider. Provider services and beneficiaries were aggregated at the county level. Rural-Urban Continuum Codes were used to assign counties to rural versus urban designations.

The results suggest that urban MNT providers may administer more services and see more patients on average than rural MNT providers. There may also be either a greater need for MNT services in rural areas where available or an inability to meet full demand in urban counties. Services also vary geographically.

Rural and Underserved Health Research Center
Christian Rhudy, Eugene Shin, Jeffery Talbert