Medicare Advantage (MA)

Current Projects

• A Closer Examination of Rural Hospital Bypass
  This project will estimate the rural hospital bypass rate using all-payer claims data for a set of states and compare patients based on the inpatient treatments and procedures received relative to those routinely provided by rural facilities.
  Research center: Rural Health Equity Research Center
  Topics: Critical Access Hospitals (CAHs), Health reform, Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Minority health, Private health insurance, Uninsured and underinsured
  
• Changes in Rural Health Insurance Coverage, 2020-2023
  This project uses secondary data sources to characterize changes in health insurance coverage during the public health emergency (2020-2023) for rural and urban people according to demographic, employment, and geographic characteristics, and to describe how changes in federal policies impacted coverage. Researchers also assess the potential impact of maintaining more robust marketplace subsidies on rural and urban coverage rates once the "unwinding" of continuous Medicaid enrollment is complete.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Health reform, Healthcare financing, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Rural statistics and demographics, Uninsured and underinsured
  
• Comparing Utilization and Quality of Home Health Care Between Medicare Fee-for-Service and Medicare Advantage Beneficiaries by Rural-Urban Status
  This project examines differences in home health use and quality by enrollment in Medicare Fee-for-Service (FFS) versus Medicare Advantage (MA) plans. Findings will include information on rural-urban and intra-rural variation in home health care to inform policies on access, payment, and quality for Medicare FFS and MA plans.
  Research center: WWAMI Rural Health Research Center
  Topics: Aging, Allied health professionals, Health disparities and health equity, Health services, Healthcare access, Healthcare financing, Home health, Medicare, Medicare Advantage (MA), Post-acute care, Quality
  
• Evaluating the Impact of Inflation Reduction Act Provisions on Medicare Advantage Prescription Drug Costs
  Using Merative MarketScan data, this study will evaluate changes in the affordability of prescription drugs for urban and rural Medicare beneficiaries before and after the recent Inflation Reduction Act (IRA). The primary outcome will be an assessment of whether the IRA succeeded in reducing costs and identifying any remaining health disparities.
  Research center: Rural and Underserved Health Research Center
  Topics: Health disparities and health equity, Healthcare financing, Medicare Advantage (MA), Pharmacy and prescription drugs
  
• Examining Post-Acute Care Utilization and Outcomes for Rural Medicare FFS and Medicare Advantage Beneficiaries
  This study will describe differences in post-acute care utilization and post-discharge outcomes between rural Medicare Fee-for-Service beneficiaries and rural Medicare Advantage beneficiaries overall and by region of the country, levels of rurality, and race and ethnicity.
  Research center: Rural Health Equity Research Center
  Topics: Care management, Critical Access Hospitals (CAHs), Healthcare access, Home health, Medicare, Medicare Advantage (MA), Post-acute care
  
• Hierarchical Condition Category (HCC) Risk Scores: Designed to Predict Future Cost and Health Care Resource Use – Do They Also Accurately Reflect Differences in Health Status between Rural and Urban Beneficiaries?
  This CMS Hierarchical Condition Category (CMS-HCC) risk score study will investigate differences in underlying health between rural and urban populations using recent data and analyze which factors drive observed differences.
  Research center: Rural Health Equity Research Center
  Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA)
  
• Medicare Advantage and Financial, Hospital, and Community Characteristics of Rural Hospitals
  This project will compare financial, hospital, and community differences among rural hospitals located in areas with lower versus higher rates of Medicare Advantage penetration.
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Hospitals and clinics, Medicare, Medicare Advantage (MA)
  
• Non-Metropolitan/Metropolitan Differences in Barriers to Care and Utilization of Preventive Care and Wellness Visits Among Traditional Medicare and Medicare Advantage
  This project proposes 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 and Urban Sepsis Outcomes as a Measure of Health Care Quality: A Nationwide Comparative Analysis Using HCUP Data
  This study examines differences in sepsis prevalence, outcomes, costs, and treatment between rural and urban hospitals using the HCUP Nationwide Readmissions Database. It aims to inform policies related to access to timely, high-quality sepsis care and identify strategies to enhance healthcare outcomes across diverse hospital settings.
  Research center: Rural Health Equity Research Center
  Topics: Care management, Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Health disparities and health equity, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Quality, Social determinants of health
  
• Rural Implications of Increased Medicare Beneficiary Enrollment in ACOs and MA Plans
  This project will leverage 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)
  
• Rural-Urban Differences in Medicare Advantage Plan Quality Scores
  This project updates previous RUPRI Center publications focused on rural-urban differences in access to, and enrollment in, Medicare Advantage plans with four- and five-star quality ratings.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Health services, Healthcare financing, Medicare, Medicare Advantage (MA)