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Rural Health
Resources by Topic: Medicare

Medicare Prescription Drug, Improvement, and Modernization Act of 2003
Text of the legislation that adds a prescription drug benefit to Medicare and enhances some rural healthcare programs, such as the Critical Access Hospitals program.
Date: 11/2003
Type: Document
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Rural-Urban Issues in the Wage Index Adjustment for Prospective Payment in Skilled Nursing Facilities
Discusses the use of the hospital wage index for the skilled nursing facility prospective payment system (SNF PPS) and how a change to an SNF wage index would impact rural and urban skilled nursing facilities. Also identifies some related issues that impact reimbursement to SNFs in both urban and rural areas.
Additional links: Findings Brief, January 2004
Author(s): Kathleen Dalton, Rebecca Slifkin
Date: 11/2003
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Physician Payment: Practice Expense
Describes the variation in Medicare payment for practice expense using the Geographic Practice Cost Indexes (GPCIs). Explains the factors that are used to calculate GPCIs and lists the 2003 GPCIs. Discusses potential impact of lower Medicare reimbursement to rural physicians for practice expense.
Author(s): A. Clinton MacKinney, Timothy D. McBride, Michael D. Shambaugh-Miller, Keith J. Mueller
Citation: RUPRI Rural Policy Brief, 8(9)
Date: 10/2003
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Availability and Use of Health Plan Choices in Rural America: Medicare+Choice, Commercial HMO, and Federal Employees Health Benefit Program Plans
Discusses availability of Medicare+Choice (M+C), commercial HMO, and Federal Employee Health Benefit Program (FEHBP) insurance plans, and the potential impact of M+C service delivery area changes on healthcare access in rural areas.
Author(s): Timothy McBride, Courtney Andrews, Keith Mueller, Michael Shambaugh-Miller
Date: 10/2003
Type: Document
Sponsoring organizations: RUPRI Center for Rural Health Policy Analysis, Rural Policy Research Institute
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Ambulance Services: Medicare Payments Can be Better Targeted to Trips in Less Densely Populated Rural Areas
Covers factors that affect ambulance costs per trip, how these factors vary across geographic areas, and how well Medicare payments account for geographic cost differences.
Additional links: Full Report
Date: 09/2003
Type: Document
Sponsoring organization: Government Accountability Office
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Enrollment in FEHBP Plans in Rural America: What are the Implications for Medicare Reform?
Discusses how the Federal Employees Health Benefits Program (FEHBP) functions in rural areas. FEHBP is being considered as a model for how private plans could be incorporated into the Medicare program and how an outpatient prescription drug benefit could be added.
Additional links: State-by-State FEHBP Enrollment Analysis, State-by-State FEHBP Enrollment Analysis, by County and Plan
Author(s): Timothy McBride, Keith Mueller, Courtney Andrews, Liyan Xu, Roslyn Fraser
Citation: RUPRI Rural Policy Brief, 8(8)
Date: 06/2003
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Variation and Innovation in Medicare
Analyzes variation within the Medicare program and explores a variety of possible payment innovations. Includes some rural-specific information. Geographic, market, quality, hospital financial performance, and use of physician services variations are covered. Also examines Medicare's reimbursement for Part B drugs. Recommendations include quality incentives and competitive pricing.
Date: 06/2003
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Analysis of Availability of Medicare + Choice, Commercial HMO, and FEHBP Plans in Rural Areas: Implications for Medicare Reform
Examines viability of introducing private competition into the Medicare program. Discusses availability of Medicare+Choice (M+C), commercial HMO, and Federal Employees Health Benefits Program (FEHBP) plans in rural (nonmetropolitan) counties.
Author(s): Timothy McBride, Courtney Andrews, Keith Mueller, Michael Shambaugh-Miller
Citation: RUPRI Rural Policy Brief, 8(5)
Date: 03/2003
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare Payment Policy, 2003
Report to the Congress. Reviews the Medicare prospective payment systems (PPSs) for seven sectors: hospital inpatient, hospital outpatient, physician, skilled nursing, home health, outpatient dialysis, and ambulatory surgical center services. Also discusses broader issues related to Medicare payments. Includes recommendations. Appendix with data on hospital financial performance for 1991-2000.
Date: 03/2003
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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An Assessment of Proposals for a Medicare Outpatient Prescription Drug Benefit: The Rural Perspective
Assesses legislative proposals to add an outpatient prescription drug benefit to the Medicare program and their implications for the delivery of services and the welfare of beneficiaries in rural areas.
Author(s): Andrew F. Coburn, Charles W. Fluharty, J. Patrick Hart, et al.
Date: 01/2003
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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