Statement of the problem: Prior to the start of the Medicare Part D program, rural beneficiaries were less likely than urban beneficiaries to have prescription drug coverage. Recent studies have analyzed the availability of Part D plans in rural areas and rural beneficiary enrollment in Medicare Part D plans, but the impact of Medicare Part D on rural beneficiaries has not been examined.

Project goals: The purpose of this project is to assess the impact of the Medicare Part D Program on medication access and the health status of rural Medicare beneficiaries. We will assess access to drugs, satisfaction with drug plans, use of pharmacies of choice, out of pocket drug expenditures, and health and functional outcomes.

Methods: Data from the Medicare Current Beneficiary Survey will be used to estimate a difference-in-differences model and measure changes in drug utilization and costs for rural Medicare beneficiaries. Two part models will be used to address enrollment in Part D and the factors that influence levels of prescription utilization and cost. Multivariate regression models will be used to analyze the relationship between health care utilization and health and functional outcomes, as well as satisfaction with care. Descriptive analyses will be used to document the most recent trends in rural enrollees' health and functional status, access to care, and plan satisfaction.

Anticipated Publications or Products: A final report and policy brief, a peer-reviewed journal manuscript, and abstracts for presentations at regional and/or national conferences.

Publications

• 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.