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Rural Health
Research Gateway

Private health insurance

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2024

  • Rural Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces: An Updated Analysis
    The project described variations in Health Insurance Marketplace plan design and availability, total and net-of-subsidy premium trends, and enrollment over time between rural and urban areas and identified associations between these factors and several key policy differences and changes, controlling for economic and demographic variation.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health reform, Healthcare access, Private health insurance, Rural statistics and demographics, Uninsured and underinsured

2023

  • Rural Health Access: Affordability and Barriers to Care
    Rural-urban comparisons of healthcare access and affordability predate many policy reform efforts aimed at increasing access and decreasing costs—ongoing concerns of rural families. This study used national health survey data to examine rural-urban differences in access to medical care, access to insurance, and affordability of care.
    Research center: Maine Rural Health Research Center
    Topics: Health reform, Health services, Healthcare access, Healthcare financing, Private health insurance, Public health, Social determinants of health

2020

  • Understanding Trends in Telehealth Use: An All-Payer Analysis in Maine
    This project's primary purpose was 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 had changed over time (2008-2017) among rural and urban patients and providers.
    Research center: Rural Telehealth Research Center
    Topics: Medicare, Private health insurance, Telehealth

2019

  • An Empirical Study of Health Insurance Firm Participation over Time in Rural Counties
    We examined changes in firm participation in multiple health insurance markets (FEHBP, MA, HIMs) over time in rural counties. We had hypothesized that participation would be related inversely to population density, because it becomes more difficult to spread risk, and network formation becomes more challenging when primary and specialty care becomes less available.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Medicare Advantage (MA), Private health insurance
  • The Rural/Urban Impact of Insurance Coverage Changes
    We examined the impacts of changes in health insurance coverage during the last several years on use of health services and health outcomes separately for rural and urban areas. Due to differences in demand and supply level factors, we hypothesized that the effects of coverage changes differ by rural/urban status.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health services, Private health insurance

2017

  • Knowledge of Health Insurance Concepts and the Affordable Care Act Among Rural Residents
    Using the Health Reform Monitoring Survey (HRMS), this project will produce two briefs examining rural-urban comparisons in insurance status, open enrollment knowledge and perceptions, and perceived affordability of coverage available through the Health Insurance Marketplaces.
    Research center: Maine Rural Health Research Center
    Topics: Health reform, Private health insurance, Rural statistics and demographics
  • State Policy Issues That May Impact HIMs' Success in Rural Places: A Regional Analysis
    Goals of this project include gathering detailed data and providing analysis and policy recommendations on issues relating to network adequacy and service areas for HIMs, with additional investigation of other state-level policy variables (such as the Medicaid expansion decision) which may have a confounding or moderating effect on the relationship between network adequacy and enrollees' choices and premiums.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health information technology, Legislation and regulation, Medicaid and CHIP, Private health insurance, Telehealth

2016

  • How Have Changes in Insurance Coverage Under Health Reform Affected Uncompensated Care and Financial Performance in Rural Hospitals?
    This two-year project will explore the effects of changes in insurance coverage under health reform on the following outcomes in rural hospitals: (1) bad debt; (2) charity care; (3) payer mix (Medicare, Medicaid, other); (3) financial performance; and (4) hospital revenue cycle management. Results will inform federal and state agencies, rural providers and communities as to how implementation of the Patient Protection and Affordable Care Act is impacting reimbursement and financial performance of rural hospitals, allowing the Office of Rural Health Policy to identify emerging challenges and develop strategies or policy changes needed to deal with any unintended consequences.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Hospitals and clinics, Private health insurance, Uninsured and underinsured
  • How Have Changes in Insurance Coverage Under Health Reform Affected Uncompensated Care and Financial Performance in Rural Hospitals? (Year 2)
    The second year of this two-year project will explore the effects of changes in insurance coverage under health reform on the following outcomes in rural hospitals: (1) bad debt; (2) charity care; (3) payer mix (Medicare, Medicaid, other); and (4) financial performance.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Healthcare financing, Medicaid and CHIP, Medicare, Private health insurance, Uninsured and underinsured
  • Role and Early Impact of CO-OPs in the Rural Health Insurance Marketplace
    This study will combine quantitative analysis with administrative health plan practice data with targeted case studies to examine the rural availability and pricing of CO-OP plans, and the early experiences of these plans.
    Research center: Maine Rural Health Research Center
    Topic: Private health insurance

2015

2014

  • Prevalence and Impact of High Deductible Health Insurance Plans in Rural Areas
    This study will use national health survey data to examine whether privately insured rural residents are more likely than their urban counterparts to have plans with high deductibles. It will also assess whether high deductible health plans create health care barriers for rural residents, and if these differ from the barriers experienced by those in urban areas.
    Research center: Maine Rural Health Research Center
    Topic: Private health insurance
  • Rural Inclusion in the Development of Health Insurance Exchanges
    State plans for developing Health Insurance Exchanges (HIEs) will be analyzed to determine likely benefits for rural residents and communities. Three elements of each plan will be described and assessed: strategies to seek out and enroll rural residents eligible for subsidized insurance coverage or categorically eligible for plans offered through exchanges; minimum standards for participating health plans, including access to essential services; and simulations of impact on availability of plans and enrollment of currently uninsured rural residents.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Private health insurance, Uninsured and underinsured
  • Will Health Insurance Marketplaces Deliver Affordable Options in Rural America
    This project analyzes early Health Insurance Marketplaces plan and premium data by geographic region, controlling for state policy decisions, to assess the degree to which affordable health insurance will be available through individual and/or small business marketplaces.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health reform, Private health insurance

2013

  • Assessing Rural Implications of Changes in Insurance Markets
    The goal of this project is to understand and predict changes in the insurance market in which rural people will participate and how state and national policies might influence activity in that market. The specific objectives of the project are to analyze state policies designing and implementing health insurance exchanges and to model the behavior of health insurance plans as regards entering and exiting rural markets.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health services, Private health insurance

2012

  • How Would Health Insurance Exchanges Work in Rural America?
    The passage of the Patient Protection and Affordable Care Act (PPACA) of 2010 has created the potential for states to create Health Insurance Exchanges (HIEs). This project will assess the potential of these plans to meet the needs of rural residents. Empirical work will establish baseline measures of choices available to rural residents and literature reviews will yield prospective analysis of how exchanges could operate to benefit rural residents.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health reform, Private health insurance

2011

2009

  • Expanding Rural Health Insurance Coverage: How Do Insurance Reform Strategies Stack Up?
    This purpose of this study is to inform policymakers about the current state of health insurance coverage in rural America, and to assess how specific reform strategies may differentially affect rural residents. Using a combination of analytic strategies, we will provide policymakers and rural health advocates with the necessary tools to develop reform strategies that meet the needs of rural residents.
    Research centers: Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
    Topics: Health reform, Private health insurance, Uninsured and underinsured

2008

  • Financial Impact of Mental Health Services on Rural Individuals and Families
    This project will use the Medical Expenditure Panel Survey (MEPS) to examine the financial burden that rural residents face in seeking mental health services, compared to urban residents. Implications of financial burden for access to needed mental health services for rural residents will be assessed.
    Research center: Maine Rural Health Research Center
    Topics: Healthcare financing, Mental and behavioral health, Private health insurance

2006

2003