This project provides rapid and flexible analysis of Centers for Medicare and Medicaid Services (CMS) data in response to requests from the federal Office of Rural Health Policy (ORHP) staff, which often requires information that is only available through analysis of databases maintained by CMS. To fully supply information needed to support rural health policy development and evaluation, these databases need to be transformed into analysis files and linked to geographic identifiers and demographic characteristics, requiring data storage capacity, statistical and geographic information system (GIS) software, demographic data files and computer programming expertise. This project will make use of secondary data files archived at the University of North Carolina Rural Health Research & Policy Analysis Center, including datasets on Medicare provider costs and revenues, health professional supply, healthcare organizations and population characteristics. Work will be ongoing.

Publications

• 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.
• December 2009: Rural Medicare Advantage Enrollment Grows 15% in 2009
  RUPRI Center for Rural Health Policy Analysis
  Date: 01/2010
  Rural enrollment in Medicare Advantage (MA) and other prepaid plans grew by 15% from December 2008 to December 2009. Preferred provider organization plans drove the increased enrollment in MA plans in rural areas in 2009, while private fee-for-service plans continued to dominate the market with over 50% of enrollment.
• 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.
• Increases in Primary Care Physician Income Due to the Patient Protection and Affordable Care Act of 2010--Continued Tweaking of Physician Payment
  Policy Brief
  RUPRI Center for Rural Health Policy Analysis
  Date: 08/2010
  In this brief, the Affordable Care Act-authorized primary care payment adjustments are modeled in a prototypical rural primary care practice to assess both the potential impact on physician personal income and the likelihood that the changes will achieve the desired policy outcome.
• 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.
• June 2011: Rural Medicare Advantage Enrollment Update
  RUPRI Center for Rural Health Policy Analysis
  Date: 09/2011
  This brief shows increases in enrollment into Medicare Advantage plans in rural America. The enrollment is concentrated in plans offered by three firms, especially in the types of plans with high rural enrollment, which are preferred provider organizations and private fee-for-service plans.
• Loss of Community Pharmacies Since 2006: State Experiences
  RUPRI Center for Rural Health Policy Analysis
  Date: 04/2009
  This brief presents the latest data from a continuous monitoring of the status of rural pharmacies by the RUPRI Center. The brief includes a table showing the data by state.
• March 2011: Growth in PPOs Dominates the Rural MA Market in 2011
  Policy Brief
  RUPRI Center for Rural Health Policy Analysis
  Date: 04/2011
  From March 2010 to March 2011, rural Medicare Advantage (MA) enrollment in preferred provider organization (PPO) plans grew from 28% (396,006 enrollees) to 46% (702,315 enrollees) of total enrollment, while rural MA enrollment in private-fee-for-service plans fell from 38% (530,678 enrollees) to 16% (249,499 enrollees).
• 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.
• Rural Enrollment in Medicare Advantage: Growth Slows in 2008
  Policy Brief
  RUPRI Center for Rural Health Policy Analysis
  Date: 03/2009
  The rate of growth of enrollment in the Medicare Advantage program decreased significantly in 2008, compared to previous years. The growth rate in preferred provider organization plans in rural areas now exceeds that in private fee-for-service plans. This updates earlier findings from analysis of the MA program reported by the RUPRI Center.
• Rural Health Snapshot 2010
  Rapid Response to Requests for Rural Data Analysis
  Date: 08/2010
  The Rural Health Snapshot displays selected indicators of access to healthcare, health behavior/risk factors, and mortality rates, comparing rural to urban residents.
• Rural Medicare Advantage 2011: Enrollment Trends and Plan Characteristics
  RUPRI Center for Rural Health Policy Analysis
  Date: 10/2011
  This paper reports findings from Centers for Medicare and Medicaid Services data analysis to examine the trends/geographic variations in Medicare Advantage (MA) plan enrollment, premiums, and market concentration by firm. The data provide an overview of the MA program in rural America and highlight key rural/urban differences within the program.
• Rural Medicare Advantage: Modest Enrollment Growth in 2010
  RUPRI Center for Rural Health Policy Analysis
  Date: 08/2010
  Despite a slight drop in enrollment and a dramatic shift in the landscape of the rural Medicare Advantage (MA) market in early 2010, MA plans have experienced modest growth in enrollment in rural areas during the last two quarters of 2010. The majority of the growth is concentrated in preferred provider organization plans.
• Rural Primary Care Physician Payment 2006-2009: What a Difference Three Years Doesn't Make
  RUPRI Center for Rural Health Policy Analysis
  Date: 11/2009
  The analysis in this brief shows the impact of Medicare's Evaluation and Management (E&M) service valuation adjustment (implemented January 1, 2007) on two prototypical primary care practices—one providing only E&M services and the other providing a mix of procedures and E&M services.
• September 2010: Rural Medicare Advantage Enrollment Update
  RUPRI Center for Rural Health Policy Analysis
  Date: 11/2010
  Rural enrollment in Medicare Advantage (MA) plans grew to nearly 1.5 million enrollees in September 2010 (15% of eligible Medicare beneficiaries), while national MA enrollment grew to more than 11.5 million (25%). Rural Medicare beneficiaries will find fewer options for MA health insurance coverage in 2011.