Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics.

Area of Science:

• Health Services Research
• Health Policy
• Rural Health

Background:

• The Medicare Advantage (MA) program offers Medicare beneficiaries private plan options instead of traditional fee-for-service (FFS) Medicare.
• Understanding rural and urban disparities in MA enrollment is crucial for effective policy development.

Purpose of the Study:

• To examine rural-urban differences in Medicare Advantage and FFS populations.
• To assess MA issuer market entry strategies based on demographic characteristics and rurality.

Main Methods:

• Utilized data from the 2012-13 Medicare Current Beneficiary Survey (MCBS).
• Combined MCBS data with county-level MA issuer participation data.
• Analyzed demographic characteristics, health status, access measures, and costs.

Main Results:

• Rural and urban populations exhibited minimal differences in demographics, health status, and frailty indicators.
• Access measures were largely similar, but rural enrollees were more likely to pay extra premiums for MA coverage (54% vs. 42%).
• Rurality was a significant predictor of lower MA issuer participation, but other demographics did not alter this prediction.

Conclusions:

• Medicare beneficiaries in rural and urban areas are demographically similar, but rural enrollees face higher out-of-pocket costs for Medicare Advantage.
• MA issuers do not appear to selectively avoid rural counties based on beneficiary demographics beyond rurality itself.