Publications

Policy Briefs

2025

• Evaluating Medicare Advantage Benchmark Setting Methodology on Rural Counties Brief No. 2025-2
• March 2024: Medicare Advantage Enrollment Update Brief No. 2025-1

2024

• Financial Performance of Rural and Urban Hospitals in the Medicare Shared Savings Program Brief No. 2024-5
• Changes in Rural Pharmacy Presence 2023 Brief No. 2024-4
• Medicare Advantage Plan Growth in Rural America: Availability of Supplemental Benefits Brief No. 2024-3
• Partnerships to Address Social Needs across Metropolitan and Non-Metropolitan Prospective Payment System Hospitals and Critical Access Hospitals Brief No. 2024-2
• Nonmetropolitan Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces in 2022 Brief No. 2024-1

2023

• Medicare Advantage Enrollment Update 2023 Brief No. 2023-9
• Distributional Analysis of Variation in Medicare Advantage Participation Within and Between Metropolitan, Micropolitan, and Noncore Counties Brief No. 2023-8
• Spatial Clustering of COVID-19 Mortality Rates across Counties and by Noncore, Micropolitan, and Metropolitan County Characteristics, December 2020–January 2021 Brief No. 2023-7
• Differences in the Merit-based Incentive Payment System (MIPS) Performance of Clinicians in Metropolitan and Nonmetropolitan Counties in 2018 Brief No. 2023-6
• COVID-19 Vaccination Rates Brief No. 2023-5
• Financial Risk Acceptance among Rural Health Care Providers Participating in the Quality Payment Program Brief No. 2023-4
• Medicare Advantage Enrollment Update 2022 Brief No. 2023-3
• Changes in Service Offerings Post-System Affiliation in Rural Hospitals Brief No. 2023-2
• COVID-19 Mortality Rates across Noncore, Micropolitan, and Metropolitan Counties by Community Characteristics, December 2020-January 2021 Brief No. 2023-1

2022

• Health Insurance Marketplaces: Issuer Participation Trends in Non-Metropolitan Places, 2014-22 Brief No. 2022-4
• Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021 Brief No. 2022-3
• Medicare Beneficiary Access to Prescription Drugs in Rural Areas Brief No. 2022-2
• Rural and Urban Pharmacy Presence – Pharmacy Deserts Brief No. 2022-1

2021

• Medicare Advantage Enrollment Update 2021 Brief No. 2021-7
• COVID-19 Cases and Vaccination Rates Brief No. 2021-8
• Medicare Advantage Enrollment Update 2020 Brief No. 2021-6
• Sources of Insurance Coverage in Nonmetropolitan Areas: The Role of Public and Private Insurance Since 2009 Brief No. 2021-5
• Geographic Expansion of Medicaid Managed Care Organizations: Assessing Access to Primary Care in Nonmetropolitan Counties Brief No. 2021-4
• Availability of Supplemental Benefits in Medicare Advantage Plans in Rural and Urban Areas Brief No. 2021-3
• High-Functioning Rural Medicare ACOs - A Qualitiative Review Brief No. 2021-2
• Trends in Nursing Home Closures in Nonmetropolitan and Metropolitan Counties in the United States: 2008-2018 Brief No. 2021-1

     All RUPRI COVID-19 Publications

2020

• Pharmacy Vaccination Service Availability in Nonmetropolitan Counties Brief No. 2020-10
• COVID-19 Cases and Deaths, Metropolitan and Nonmetropolitan Counties Over Time Brief No. 2020-9
• Medicare Advantage Enrollment Update 2019 Brief No. 2020-8
• Telepharmacy Rules and Statutes: A 3-Year Update for all 50 States Brief No. 2020-7
• Access to Medicare Part D Plans: A Comparison of Metropolitan and Nonmetropolitan Areas Brief No. 2020-5
• County-Level 14-Day COVID-19 Case Trajectories Brief No. 2020-6
• Metropolitan/Nonmetropolitan COVID-19 Confirmed Cases and General and ICU Beds Brief No. 2020-4
• Health Care Professional Workforce Composition before and after Rural Hospital Closure Brief No. 2020-3
• Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties Brief No. 2020-2
      - Previous versions
• Rural Hospital Participation in Medicare Accountable Care Organizations Brief No. 2020-1

2019

• Impact of the Medicare Disproportionate Share Hospital Payment Cap on Rural and Urban Hospitals Brief No. 2019-6
• Effects of the Patient Protection and Affordable Care Act on Coverage and Access to Care in Metropolitan vs. Non-Metropolitan Areas through 2016 Brief No. 2019-5
• Insurer Participation in Rural Health Insurance Marketplaces: Are Some Markets Intrinsically More Competitive Than Others? Brief No. 2019-4
• Primary Care Clinician Participation in the CMS Quality Payment Program Brief No. 2019-3
• Medicare Advantage Enrollment Update 2018 Brief No. 2019-2
• Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics Brief No. 2019-1

2018

• Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018 Brief No. 2018-6
• Trends in Hospital System Affiliation, 2007-2016 Brief No. 2018-5
• Spread of Medicare Accountable Care Organizations in Rural America Brief No. 2018-4
• Health Insurance Marketplaces: Issuer Participation and Premium Trends in Rural Places, 2018 Brief No. 2018-3
• Update: Independently Owned Pharmacy Closures in Rural America, 2003-2018 Brief No. 2018-2
• Medicare Accountable Care Organization Growth in Rural America, 2014–2016 Brief No. 2018-1
      - Supplemental Tables and Maps

2017

• Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update Brief No. 2017-7
• Distribution of Disproportionate Share Hospital Payments to Rural and Critical Access Hospitals Brief No. 2017-6
• Medicare Advantage Enrollment Update - March 2017 Brief No. 2017-5
      National and State Enrollment Tables and Maps
• Telepharmacy Rules and Statutes: A 50-State Survey Brief No. 2017-4
      - Supplemental Table
• Issues Confronting Rural Pharmacies after a Decade of Medicare Part D Brief No. 2017-3
• Changing Rural and Urban Enrollment in State Medicaid Programs Brief No. 2017-2
• Rural Enrollment in Health Insurance Marketplaces, by State Brief No. 2017-1

2016

• Medicare Accountable Care Organizations: Quality Performance by Geographic Categories Brief No. 2016-6
• Spread of Accountable Care Organizations in Rural America Brief No. 2016-5
• Medicare Advantage Enrollment Update 2016 Brief No. 2016-4
• Rural Medicare Advantage Market Dynamics and Quality: Historical Context and Current Implications Brief No. 2016-3
• Health Insurance Marketplaces: Premium Trends in Rural Areas Brief No. 2016-1
• Medicare Accountable Care Organizations: Beneficiary Assignment Update Brief No. 2016-2

2015

• Rural Medicare Advantage Plan Payment in 2015 Brief No. 2015-12
• Medicare Value-based Payment Reform: Priorities for Transforming Rural Health Systems A RUPRI Panel Brief
• Rural Enrollment in Health Insurance Marketplaces, by State Brief No. 2015-11
• Rural Enrollment in Health Insurance Marketplaces Brief No. 2015-10
• 2015: Rural Medicare Advantage Enrollment Update Brief No. 2015-9
• Characteristics of Rural Accountable Care Organizations (ACOs) – A Survey of Medicare ACOs with Rural Presence Brief No. 2015-8
• Health Insurance Marketplaces: Early Findings on Changes in Plan Availability and Premiums in Rural Places, 2014-2015 Brief No. 2015-7
• Characteristics of Rural Communities with a Sole, Independently Owned Pharmacy Brief No. 2015-6
• Hospital Views of Factors Affecting Telemedicine Use Brief No. 2015-5
• A Rural Taxonomy of Population and Health-Resource Characteristics Brief No. 2015-4
     - Technical Report
     - Maps and Tables
• Developmental Strategies and Challenges of Rural Accountable Care Organizations Brief No. 2015-3
• Surgical Services in Critical Access Hospitals, 2011 Brief No. 2015-2
• Medicare Advantage Enrollment Update: March 2014 Brief No. 2015-1

2014

• Advancing the Transition to a High Performance Rural Health System
      RUPRI Health Panel Paper
      RUPRI Health Panel Brief
• Geographic Variation in Premiums in Health Insurance Marketplaces Brief No. 2014-10
• Facilitating the Formation of Accountable Care Organizations in Rural Areas Brief No. 2014-9
• The Effect of Medicare Payment Policy Changes on Rural Primary Care Practice Revenue Brief No. 2014-8
      - Supplemental table
• Update: Independently Owned Pharmacy Closures in Rural America, 2003-2013 Brief No. 2014-7
• Trends in Hospital Network Participation and System Affiliation, 2007-2012 Brief No. 2014-6
• A Guide to Understanding the Variation in Premiums in Rural Health Insurance Marketplaces Brief No. 2014-5
• Extent of Telehealth Use in Rural and Urban Hospitals Brief No. 2014-4
• Medicare Accountable Care Organizations: Program Eligibility, Beneficiary Assignment, and Quality Measures Brief No. 2014-3
• The Uninsured: An Analysis by Age, Income, and Geography Brief No. 2014-2
• 2012 Rural Medicare Advantage Quality Ratings and Bonus Payments Brief No. 2014-1

2013

• Assessing the Impact of Rural Provider Service Mix on the Primary Care Incentive Payment Program Brief No. 2013-16
• Demographic and Economic Characteristics Associated with Sole County Pharmacy Closures, 2006-2010 Brief No. 2013-15
• Medicare Advantage Enrollment Update: March 2013 Brief No. 2013-14
• Causes and Consequences of Rural Pharmacy Closures: A Multi-Case Study Brief No. 2013-11
• The Frontier Extended Stay Clinic Model: A Potential Health Care Delivery Alternative for Small Rural Communities Brief No. 2013-9
       Appendix
• Accountable Care Organizations in Rural America Brief No. 2013-7
       National and regional maps
• The Uninsured: An Analysis by Income and Geography Brief No. 2013-6
• Rural Implications of the Primary Care Incentive Payment Program Brief No. 2013-5
• September 2012: Medicare Advantage Enrollment Update Brief No. 2013-3
• Rural MA Enrollment and Premium Update: June 2012 Brief No. 2013-2
• Rural Pharmacy Closures: Implications for Rural Communities: February 2013 Brief No. 2012-5

2012

• Update: Independently Owned Pharmacy Closures in Rural America: July 2012 Brief No. 2012-4
• Rural Medicare Advantage Enrollment Update Brief No. 2012-3

2011

• Rural Medicare Advantage Enrollment Update Brief No. 2011-8
• Patient-Centered Medical Home Services in 29 Rural Primary Care Practices: A Work in Progress Brief No. 2011-6
• Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions in the United States, by Insurance Type, 2000-2004 Brief No. 2011-4
• Independently Owned Pharmacy Closures in Rural America, 2003-2010 Brief No. 2011-5
• Rural Medicare Advantage: Growth in PPOs Dominates the Rural MA Market in 2011 Brief No. 2011-3
• Use of Health Information Technology in Support of Patient-Centered Medical Homes is Low Among Non-Metropolitan Family Medicine Practices Brief No. 2011-2
• Medicare Beneficiary Access to Primary Care Physicians — Better in Rural, but Still Worrisome Brief No. 2011-1

2010

• Rural Medicare Advantage Enrollment Update Brief No. 2010-6
• Increases in Primary Care Physician Income due to the Patient Protection and Affordable Care Act of 2010 - Continued Tweaking of Physician Payment Brief No. 2010-2
• Rural Medicare Advantage: Modest Enrollment Growth in 2010 Brief No. 2010-5
• A Dramatic Shift Away from Private Fee-for-Service Plans in Rural Medicare Advantage Enrollment Brief No. 2010-3
• Rural Medicare Advantage Enrollment Grows 15% in 2009. Brief No. 2010-1

2009
2008
2007
2006
2005
2004
2003
2002
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