Assessment of Proposals for a Medicare Outpatient Prescription Drug Benefit: The Rural Perspective

View Report This Policy Paper 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. Included are comments on five proposals introduced in the 107th Congress: one that was passed by the House of Representatives, …

Comments on the June 2001 Report of the Medicare Payment Advisory Commission: “Medicare in Rural America”

View Policy Paper The Rural Health Panel is publishing this policy paper to provide a foundation for a discussion of the recommendations and findings presented in the June 2001 report (Report) of the Medicare Payment Advisory Commission (MedPAC), Medicare in Rural America. In this paper, the Panel comments on MedPAC’s recommendations and offers a critique …

Redesigning Medicare: Considerations for Rural Beneficiaries and Health Systems

View report The enactment of the Balanced Budget Act of 1997 (BBA) dramatically changed the context for discussions of Medicare policy. Two major pathways for discussion were identified: Appropriate and equitable payment for services, either through traditional fee-for service (FFS) Medicare payments or through Medicare+Choice monthly premiums; and Appropriate and necessary changes to the program …

Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000

View Report This paper summarizes provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) and assesses the impact of those provisions on rural health care delivery. Congress passed BIPA on December 15, 2000, and President Clinton signed it on December 21. This report was written by Health Panel members: …

Designing a Prescription Drug Benefit for Rural Medicare Beneficiaries: Principles, Criteria and Assessment

View Report This paper was jointly prepared by the Maine Rural Health Research Center and the RUPRI (Rural Policy Research Institute) Rural Health Panel to offer a rural perspective on the current debate over the design and implementation of a Medicare prescription drug benefit. Background information on rural Medicare beneficiaries’ need for, and access to, …

Redesigning the Medicare Program: An Opportunity to Improve Rural Health Care Systems?

View Draft Report The enactment of the Balanced Budget Act of 1997 (BBA) changed dramatically the context for discussions of Medicare policy. Policy discussions since the BBA have sharpened two major pathways for dialogue/debate: appropriate and equitable payment for services, either through traditional Medicare fee-for-service payments or through Medicare+Choice monthly premiums; and appropriate and necessary …

The Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System

The Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System: Perspectives, Policies, and Choices View Policy Paper This policy paper discusses the positions of various rural health advocates on the wage index and recording the actions taken by Congress and the Health Care Financing Administration (HCFA) to improve the wage index.Finally, it outlines …

Improving Prescription Drug Coverage for Rural Medicare Beneficiaries: Key Rural Considerations and Objectives For Legislative Proposals

View Policy Paper This Policy Paper combines the work from current projects of the Maine Rural Health Research Center (MRHRC) and the Rural Health Panel of the Rural Policy Research Institute (RUPRI) to provide a statement of specific rural considerations and objectives for any proposal that would add a prescription drug benefit to the Medicare …

Calculating and Using the Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System

View policy brief This policy brief explains how the area wage index is calculated and used, and identifies the major unresolved issues related to its calculation and use. This report was written by Anthony Wellever (Delta Rural Health Consulting and Research) in collaboration with RUPRI Health Panel Members: Andrew Coburn, Charles Fluharty, J. Patrick Hart, …

A Rural Assessment of Leading Proposals to Redesign the Medicare Program

View Report This Policy Paper provides a critique of two proposals to redesign the Medicare program: the “Medicare Preservation and Improvement Act of 1999” (S. 1895, introduced by Senator Breaux and others) and “The President’s Plan to Modernize and Strengthen Medicare for the 21st Century.” Rural implications of the proposals are discussed, specifically how they …

A Report on Enrollment: Rural Medicare Beneficiaries in Medicare+Choice Plans

View Report This policy brief describes the experience to date with the Medicare+Choice program, focusing on changes in enrollment and plan formationthrough Fall 1999. We include a particular focus on changes occurring inrural counties. This updates previous reports by the RUPRI Health Panelon the progress of the Medicare+Choice program. This report was written by Health …