Medicare

Current Projects

  • Access to Care for Rural Medicare Beneficiaries
    This project will examine multiple dimensions of access to care, with a focus on rural Medicare beneficiaries, including rural-urban differences in access to care, and within-rural differences in access to care by region, coverage type (traditional fee-for-service vs. supplemental Medigap coverage), and socio-demographic characteristics.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Healthcare access, Medicare, Medicare Advantage (MA)
  • Assessing Potential Unmet Need for Home Healthcare in Rural Areas
    This study will estimate potential unmet need for home healthcare in rural areas for fee-for-service Medicare beneficiaries. We will compare rates of home healthcare utilization in rural areas with urban areas, accounting for acute hospital discharges and utilization of inpatient rehabilitation facilities and skilled nursing facilities.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Home health, Hospitals and clinics, Medicare, Post-acute care
  • Current and Longer Term Challenges of Rural Hospitals: A Survey of Rural Hospital Executives
    This project involves surveying rural hospital executives about how they will respond to current and long-term challenges related to financial and regulatory burdens.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Healthcare financing, Hospitals and clinics, Medicare
  • Financial Impact of Reimbursing CAH Swing Bed Days at the SNF PPS Rate
    This study will assess the financial impact of changing Critical Access Hospital (CAH) swing bed reimbursement from the cost-based system to the skilled nursing facility (SNF) prospective payment system (PPS).
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals, Healthcare financing, Long-term care, Medicare, Post-acute care
  • Geographic Access to Healthcare for Rural Medicare Beneficiaries: An Update and National Look
    This objective of this study is to compare, at a national and census division level, where rural and urban Medicare beneficiaries receive ambulatory care, which types of specialists they utilize and how far beneficiaries are traveling to obtain care.
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Chronic diseases and conditions, Health services, Medicare, Workforce
  • Health Care Use and Access Among Rural and Urban Elderly Medicare Beneficiaries
    This project will examine rural-urban differences in healthcare use and access to healthcare services among elderly Medicare enrollees using the 2011-2013 Medicare Current Beneficiary Survey. We also will identify the socioeconomic and health factors that may place rural seniors at risk for poor healthcare access.
    Research center: Maine Rural Health Research Center
    Topics: Aging, Medicare
  • Healthcare Use and Access Among Rural & Urban Non-elderly Disabled Medicare Beneficiaries
    This project will explore healthcare use and barriers to healthcare access among disabled Medicare beneficiaries under 65 in rural and urban areas. The study will be based on quantitative analyses of the 2009-2013 Medicare Current Beneficiary Survey.
    Research center: Maine Rural Health Research Center
    Topics: Disabilities, Health disparities and health equity, Medicare
  • Healthcare Use and Expenditures Among Rural and Urban Medicare Beneficiaries Aged 85 and Over
    The proportion of U.S. residents ages 85+ is expected to grow substantially in the coming decades with the impact of this growth in rural areas likely to be pronounced. This project will use data from the Medicare Current Beneficiary Survey to examine rural-urban differences in healthcare use and expenditures among Medicare enrollees ages 85+.
    Research center: Maine Rural Health Research Center
    Topics: Aging, Healthcare access, Long-term care, Medicare
  • Hospital Readmission Following Care in a Swing Bed
    This study builds on our portfolio of swing bed work by examining the rate of hospital readmission for patients who receive post-acute care in swing beds compared to skilled nursing facilities and will inform the discussion on use, cost, and benefit of swing bed care.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Post-acute care, Quality
  • How Do Costs for Rural Medicare Beneficiaries Using Swing Beds Compare to Those Using Skilled Nursing Facilities?
    This study will estimate and compare total Medicare expenditures for episodes of care that include post-acute stays in either swing beds or skilled nursing facilities (SNFs). Results will inform federal and state agencies, rural providers and communities as to how post-acute care in swing bed versus a SNF affects the trajectory of costs and utilization for rural Medicare beneficiaries.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Long-term care, Medicare, Post-acute care
  • Impact of Capping Medicare Disproportionate Share Hospital Payments on Rural Hospitals
    Rural hospitals receiving Medicare prospective payment system payment and receiving disproportionate share hospital payments are subject to a 12% cap on those payments. This project will provide information on the number and location of rural hospitals subject to this cap and the fiscal impact.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Healthcare financing, Medicare, Medicare Prospective Payment System (PPS)
  • Medicare Beneficiaries' Access to Preventive Services: Diabetes Self-Management Training, Medical Nutrition Therapy, and Health and Behavior Assessment and Intervention
    Medicare offers preventive services focused on self-management through several programs: Diabetes Self-Management Training, Medical Nutrition Therapy, and Health and Behavior Assessment and Intervention.
    Research center: Rural and Underserved Health Research Center
    Topics: Diabetes, Health promotion and disease prevention, Medicare, Obesity
  • Medicare Beneficiary Access to Prescription Drugs Under Part D
    This study will build on RUPRI Center work describing patterns of enrollment into Medicare Part D plans (including access to zero deductible plans) by using transaction files to analyze how medications are actually acquired and implications for access to local pharmacy services.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Medicare, Medicare Part D
  • Patterns of Inpatient Care-Seeking by Rural Residents
    This study seeks to gain an understanding of inpatient care-seeking behavior by rural residents to provide insight into drivers of bypass rates, the extent to which a community uses a hospital other than its local rural hospital.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health services, Hospitals and clinics, Medicare
  • Post-acute Care Trajectories for Rural Medicare Beneficiaries
    Utilization and costs of post-acute care for Medicare fee-for-service beneficiaries have grown rapidly during the last decade. This study will examine post-acute care utilization for rural Medicare beneficiaries following acute hospitalization, describing use of home health and skilled nursing care and trajectories of care across settings.
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Allied health professionals, Health services, Home health, Hospitals and clinics, Medicare, Nurses and nurse practitioners, Post-acute care
  • Rural Health Clinic Financial Performance and Productivity
    This study will use Medicare cost reports for independent and provider-based clinics to provide a detailed national picture of the financial and operational performance of RHCs and describe variations in performance related to revenue, costs, staffing, payer mix, productivity levels, and hours of operation across independent and provider-based clinics. The project will also develop measures that can be used to benchmark RHC performance over time.
    Research center: Maine Rural Health Research Center
    Topics: Medicare, Rural Health Clinics (RHCs)
  • Rural-Urban Variation in CMS Hierarchical Condition Categories (HCC) Risk Scores
    CMS uses hierarchical condition categories (HCC) to risk-adjust Medicare beneficiaries for multiple conditions. This adjustment is used for multiple programs, but it's unknown whether the adjustment works similarly in rural and urban areas. This project investigates the distribution of beneficiaries' and providers' HCC risk scores across rurality.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Medicare
  • Understanding Trends in Telehealth Use: An All-Payer Analysis in Maine
    This project's primary purpose is to use Maine's All-Payer Claims Database and key informant interviews to develop a descriptive overview of telehealth use in Maine, examining how telehealth use has changed over time (2008-2017) among rural and urban patients and providers.
    Research center: Rural Telehealth Research Center
    Topics: Medicare, Private health insurance, Telehealth
  • Utilization of Hospital Care for Rural Medicare Beneficiaries
    This project examines where rural and frontier Medicare beneficiaries access hospital care. Specifically, it explores the different types of inpatient care sought in local rural communities and at tertiary providers. Beneficiary patterns of care by condition, location type and other factors will be examined. The study will also focus on the bypassing behavior of rural residents when being hospitalized. Analysis sensitivity analyses are being performed regarding small travel time differences per alternative hospitals.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Frontier health, Hospitals and clinics, Medicare
  • What Factors Influence Rural Hospitals' Participation in Accountable Care Organizations?
    This project examines rural hospitals' participation in Accountable Care Organizations (ACOs); identifies factors that influence ACO participation; compares whether different factors influence rural/urban hospital participation in ACOs; and analyzes factors influencing Critical Access Hospitals' participation in the Medicare Shared Savings Program.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health reform, Healthcare financing, Medicare
  • What Makes Successful Rural Accountable Care Organizations Successful?
    The U.S. Department of Health and Human Services plans to shift at least 50% of traditional Medicare spending into alternative payment models by 2018. Accountable Care Organizations (ACOs) represent a popular model in both the Medicare and Medicaid programs. This study used multiple methods to find what makes a successful ACO.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Medicare, Quality
  • Who Provides Mental Health Services to Rural Medicare Beneficiaries?
    Most rural counties do not have a psychiatrist to care for the common conditions of depression or anxiety. This study will describe the provider workforce that cares for rural elderly patients with depression/anxiety, including regional and rural-urban variations in mental healthcare provision.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Medicare, Mental and behavioral health, Nurses and nurse practitioners, Physician assistants, Physicians, Substance use and treatment, Workforce