Dan Shane, PhD

RUPRI Center for Rural Health Policy Analysis

Phone: 319.384.3830
Email: dan-shane@uiowa.edu

Health Management and Policy
University of Iowa
145 N. Riverside Drive
Iowa City, IA 52242


Current Projects - (2)

  • Retention and Expansion of Hospital Services Offered by Rural Hospitals After Enrollment in 340B
    The 340B Federal program is designed to provide hospitals with financial stability through provision of drug discounts which may, in turn, allow hospitals to maintain or expand their service line offerings. Using a series of event study analyses over an 11-year period, this study will examine the impact of enrollment in the 340B program on discontinuing services, maintaining services, and adding new services in eligible rural hospitals.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Critical Access Hospitals (CAHs), Health services, Hospitals and clinics, Pharmacy and prescription drugs
  • The Changing Landscape of Medicare Advantage in Rural America
    The recent rapid growth in Medicare Advantage (MA) enrollment, particularly in counties with very little previous activity, has made MA a "hot issue" in rural health policy. This project will provide deeper knowledge of the MA marketplace including the firms offering MA plans and the beneficiaries who are enrolling.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Healthcare financing, Medicare, Medicare Advantage (MA)

Completed Projects - (3)

  • Non-Metropolitan/Metropolitan Differences in Barriers to Care and Utilization of Preventive Care and Wellness Visits Among Traditional Medicare and Medicare Advantage
    This project proposed to use the Medicare Current Beneficiaries Survey to examine differences across geography and plan type (Medicare Advantage vs. traditional) with regards to barriers to care (e.g., costs) and use of preventive services (e.g., flu shot).
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health services, Healthcare access, Medicare Advantage (MA)
  • Rural Implications of Increased Medicare Beneficiary Enrollment in ACOs and MA Plans
    This project leveraged Centers for Medicare & Medicaid Services data showing the number of Medicare beneficiaries assigned to Accountable Care Organizations, in combination with enrollment in Medicare Advantage in rural counties, to describe implications for rural health care organizations.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health reform, Healthcare financing, Medicare, Medicare Advantage (MA)
  • The Rural/Urban Impact of Insurance Coverage Changes
    We examined the impacts of changes in health insurance coverage during the last several years on use of health services and health outcomes separately for rural and urban areas. Due to differences in demand and supply level factors, we hypothesized that the effects of coverage changes differ by rural/urban status.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health services, Private health insurance

Publications - (12)

2026

  • Rural Implications of Increased Medicare Beneficiary Enrollment in ACOs and MA Plans
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2026
    Medicare beneficiaries enrolled in a Medicare Advantage (MA) plan are not eligible for attribution to a Medicare Share Savings Plan (SSP) Accountable Care Organization (ACO). This data report examines the impact of a growing MA population on the pool of beneficiaries eligible for ACO attribution.
  • Medicare Advantage Enrollment Update 2025
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 05/2026
    This brief continues RUPRI Center's annual update of Medicare Advantage (MA) enrollment including the changes in enrollment in types of MA plans, and health policy changes that may have had an impact.
  • Rural-based Accountable Care Organizations Agreement Renewal
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 02/2026
    This policy brief describes characteristics of Accountable Care Organizations participating in the Medicare Shared Savings Program (MSSP) and compares trends in exits and entries into MSSP between nonmetropolitan (rural) and metropolitan (urban) geographies from 2013 through 2022.

2025

2024

2023

2019

2017