June 2012: rural MA enrollment and premium update.

Q2 Medicine Rural policy brief Pub Date : 2013-02-01
Leah Kemper, Abigail Barker, Timothy D McBride, Keith Mueller
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Abstract

Key Data Findings. (1) Rural Medicare Advantage (MA) enrollment grew to over 1.7 million in June 2012 (17% of eligible beneficiaries), while total MA enrollment grew to nearly 13.4 million (27% of eligible beneficiaries). (2) Rural preferred provider organization (PPO) and health maintenance organization (HMO) enrollment grew to over 840 thousand (48% of the market) and 532 thousand (31% of the market), respectively, while private fee-for-service (PFFS) enrollment fell to 230 thousand in rural areas (13% of the market). (3) Rural MA enrollment varies across the country with concentrations of enrollment on the West Coast, the Great Lakes, and the Northeast regions of the United States. (4) The average monthly weighted premium for rural MA plans with prescription drugs fell in 2012 to $48 from $52 in 2011, but it remains significantly higher than the urban average which also fell during the same time from $38 to $34. (5) Zero premium plans are available to 73% of rural MA beneficiaries and to 95% of urban beneficiaries; however, only 48% of rural beneficiaries that have this option choose these plans compared to 63% of urban beneficiaries. The resulting average non-zero premium was $72 in rural areas in 2012, while the average non-zero premium in urban areas was $81. (6) Roughly a third (35%) of rural MA beneficiaries receive their MA coverage including prescription drugs without having to pay a premium, however this is significantly lower than 60% of urban beneficiaries that do not have to pay a premium.

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2012年6月:农村MA招生和保费更新。
关键数据发现。(1) 2012年6月,农村医疗保险优势(MA)注册人数增长到170多万(占合格受益人的17%),而MA总注册人数增长到近1340万(占合格受益人的27%)。(2)农村首选提供者组织(PPO)和健康维护组织(HMO)的注册人数分别增长到84万(市场份额的48%)和53.2万(市场份额的31%),而农村地区私人付费服务(PFFS)的注册人数下降到23万(市场份额的13%)。(3)全国农村MA招生情况各不相同,招生集中在西海岸、五大湖和美国东北部地区。(4)含处方药的农村MA计划的月平均加权保费从2011年的52美元下降到2012年的48美元,但仍显著高于城市平均水平,城市平均保费同期也从38美元下降到34美元。(5) 73%的农村MA受益人和95%的城市MA受益人可享受零保费计划;然而,只有48%的农村受益人选择了这些计划,而城市受益人的这一比例为63%。2012年,农村地区的平均非零保费为72美元,而城市地区的平均非零保费为81美元。(6)大约三分之一(35%)的农村综合医疗保险受益人无需支付保费即可获得包括处方药在内的综合医疗保险,但这一比例明显低于60%的无需支付保费的城市受益人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Rural policy brief
Rural policy brief Medicine-Medicine (all)
CiteScore
1.20
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Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics. Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018. Trends in Hospital System Affiliation, 2007-2016. Health Insurance Marketplaces: Issuer Participation and Premium Trends in Rural Places, 2018. Spread of Medicare Accountable Care Organizations in Rural America.
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