Medicare Part D: Rural Health Research Products & Journal Articles

2022

Medicare Beneficiary Access to Prescription Drugs in Rural Areas
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 08/2022
Declines in the number of retail pharmacies in rural areas have raised concerns about beneficiary access to prescription medications when their local pharmacy closes. The purpose of this policy brief is to identify the types of pharmacies used by beneficiaries in rural areas with limited or no access to local pharmacies.

2021

Medicare-Paid Naloxone: Trends in Nonmetropolitan and Metropolitan Areas
Policy Brief
Rural and Underserved Health Research Center
Date: 05/2021
Naloxone is an opioid overdose reversal medication. Medicare beneficiaries benefit from access to naloxone because they have high rates of high-dose prescription opioids. This brief examines trends in Medicare-paid naloxone dispensing rates in nonmetropolitan versus metropolitan areas from 2014 to 2018.

2020

Access to Medicare Part D Plans: A Comparison of Metropolitan and Nonmetropolitan Areas
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 05/2020
This policy brief updates previous reports on rural activity in the Medicare Part D program. Comparisons are made across county type, within type of Part D plan (standalone and part of Medicare Advantage plans), and between the types of plans within county classifications.

2018

Update: Independently Owned Pharmacy Closures in Rural America, 2003-2018
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 07/2018
Rural pharmacies play an important role in health service delivery to rural populations. This RUPRI Center brief updates previous findings on the continued decline in the number of independently owned rural pharmacies since the implementation of Medicare Part D. This brief provides follow-up data on rural pharmacy closures through March 2018.

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.
Financial Issues Challenging Sustainability of Rural Pharmacies
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 08/2017
Findings from a survey of rural lone community retail pharmacies about issues perceived as a threat to their sustainability. Reimbursement issues were cited as being most immediate and of highest magnitude.
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.

2016

Does the Medicare Part D Decision-Making Experience Differ by Rural/Urban Location?
Journal Article
University of Minnesota Rural Health Research Center
Date: 02/2016
Evaluates the personal experiences with choosing a Part D plan among rural residents. This study examines the geographic differences in Part D enrollees' opinion of the plans decision-making process.
Rural-Urban Differences in Satisfaction With Medicare Part D: Implications for Policy
Journal Article
University of Minnesota Rural Health Research Center
Date: 01/2016
Examines the difference in rural and urban satisfaction with Medicare Part D coverage by using data from the 2012 Medicare Current Beneficiary Survey. The research found that rural residents have lower satisfaction with their coverage.

2015

Differences in Part D Plans Offered to Rural and Urban Medicare Beneficiaries
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2015
This brief analyzes how the plan options available to rural and urban beneficiaries differ in terms of premiums, deductibles, and copayments, as well as differences in plan options within rural areas.
Rural and Urban Differences in Choice of and Satisfaction With Medicare Part D Plans
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2015
This brief examines whether rural Medicare beneficiaries are satisfied with their Medicare Part D drug plans and whether there is a difference in beneficiary satisfaction and plan selection experience by rurality.

2013

Demographic and Economic Characteristics Associated With Sole County Pharmacy Closures, 2006-2010
RUPRI Center for Rural Health Policy Analysis
Date: 11/2013
This policy brief describes demographic and economic characteristics associated with counties experiencing closure of their sole pharmacy.
Comparing Rural and Urban Medicare Part D Enrollment Patterns and Prescription Drug Coverage Rates
University of Minnesota Rural Health Research Center
Date: 05/2013
This study examines Medicare Part D enrollment rates in rural and urban areas and the resulting impact on rural beneficiaries' overall prescription drug coverage rates.

2012

Stand-Alone Prescription Drug Plans Dominated the Rural Market in 2011
RUPRI Center for Rural Health Policy Analysis
Date: 09/2012
This report shows that as of May 2011, 59.1% of rural Medicare beneficiaries were enrolled in Medicare Part D through insurance plans that provide coverage for prescription medications. It also provides further detail, including urban and rural enrollment by type of plan and by state.

2011

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.

2009

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 (PPO) 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.
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.
Sole Community Pharmacies and Part D Participation: Implications for Rural Residents (Findings Brief)
North Carolina Rural Health Research and Policy Analysis Center
Date: 02/2009
This findings brief describes the contracting rates of sole rural community pharmacies in 16 states to assess the extent to which each pharmacy contracts with the most commonly used prescription drug plans available in their state.
Medicare Beneficiaries' Access to Pharmacy Services in Small Rural Towns: Implications of Contracting Patterns of Sole Community Pharmacies With Part D Plans
North Carolina Rural Health Research and Policy Analysis Center
Date: 01/2009
This report describes the contracting patterns of sole rural community pharmacies to assess the extent to which each pharmacy contracts with the most commonly used PDPs available in their state.

2008

Eligible but Not Enrolled? Potential for Targeting Over a Half-Million Rural Medicare Beneficiaries for Enrollment in the Low-Income Subsidy Prescription Drug Program
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 12/2008
Medicare Part D low-income supplement (LIS) is designed to help low-income persons access prescription drugs with reduced premiums and lower out-of-pocket costs. Despite efforts to enroll as many eligible persons as possible, many Medicare beneficiaries are estimated to be eligible for but not enrolled in the LIS program.
Independently Owned Pharmacy Closures in Rural America
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 07/2008
This brief focuses on rural pharmacy closure because of the potential threat such closures present to access to any local pharmacy services in a community.

2007

One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D (Findings Brief)
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 10/2007
This brief describes the experiences of 51 rural independently-owned pharmacies that are the sole providers of pharmacy services in their communities one year after implementation of the Medicare Part D prescription drug benefit.
One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D (Final Report)
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 09/2007
This report describes the experiences of 51 rural, independently owned pharmacies that are the sole providers of pharmacy services in their communities one year after implementation of the Medicare Part D prescription drug benefit.
Enrollment in Medicare Part D for Rural Beneficiaries Is Encouraging
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 01/2007
This policy brief provides updated findings about Medicare beneficiary enrollment in prescription drug plans in rural and urban areas across the United States.
The Experience of Rural Independent Pharmacies With Medicare Part D: Reports From the Field
Journal Article
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 2007
Describes first-hand reports from rural pharmacist-owners about their experiences with Medicare Part D plans in the first 7 months of 2006 in order to gain a more thorough understanding of the challenges faced by rural independent pharmacies as a result of program implementation.

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 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

Preparing for Medicare Part D: An Opportunity for State Offices of Rural Health and State Rural Health Associations
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 08/2005
Keeping with their organizational missions to improve and promote the health of rural Americans, state offices of rural health and state rural health associations have an inherent interest in helping beneficiaries access necessary healthcare services, including prescription medications.
How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Preimplementation Prescription Volume and Payment Sources in Rural and Urban Areas
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2005
Presents descriptive information on mail-order prescriptions, volume, and payer type of retail prescriptions in rural vs. urban areas. Together, these data provide a baseline for evaluating how implementation of the Medicare Prescription Drug, Improvement, and Modernization Act may affect the financial viability of rural independent pharmacies.

2004

Rural Perspective Regarding Regulations Implementing Titles I and II of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
NORC Walsh Center for Rural Health Analysis, RUPRI Center for Rural Health Policy Analysis
Date: 08/2004
This policy paper provides, in chart form, sections of the MMA that were identified as having special concern to rural Medicare beneficiaries, medical care providers, and policy makers.
Medicare Prescription Drug, Improvement, and Modernization Act of 2003, (P.L. 108-173): A Summary of Provisions Important to Rural Health Care Delivery
RUPRI Center for Rural Health Policy Analysis
Date: 01/2004
This paper provides a wide audience of rural health policy makers, advocates, and researchers a consolidated summary of legislative provisions contained in Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173) that have particular meaning to the delivery of services in rural areas.

2003

Rural Beneficiaries' Projected Drug Coverage Under Three Medicare Prescription Drug Proposals
NORC Walsh Center for Rural Health Analysis
Date: 06/2003
This study estimates the expected increase in urban and rural Medicare beneficiaries eligible for drug coverage under three Medicare prescription drug proposals. It also gives an estimate of the urban and rural per capita federal payments for drug coverage under the proposals.
Designing a Medicare Drug Benefit: Balancing Government-Based and Market-Based Approaches, the Implications for Rural Beneficiaries
NORC Walsh Center for Rural Health Analysis
Date: 01/2003
This study examines the relationship between various Medicare prescription drug benefit design characteristics and their impact on rural areas based on analysis of competing legislative proposals.

2001

Access to Rural Pharmacy Services in Minnesota, North Dakota, and South Dakota
University of Minnesota Rural Health Research Center
Date: 07/2001
This paper describes the status of rural retail pharmacies in the three states; examines the availability of pharmacy services in rural areas of the states; and analyzes regulatory and policy issues that affect the delivery of pharmacy services in rural areas.

2000

Designing a Prescription Drug Benefit for Rural Medicare Beneficiaries: Principles, Criteria, and Assessment
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
Date: 08/2000
This paper offers a rural perspective on the debate about the design/implementation of a Medicare prescription drug benefit. Background information on rural Medicare beneficiaries' need for, and access to, prescription drugs is provided, along with a set of rural-oriented principles for use in evaluating how various proposals may meet rural needs.