Kemper Leah, Barker Abigail R, McBride Timothy D, Mueller Keith
Rural Policy Brief. 2014 Jan 1(2014 1):1-4.
Key Data Findings. (1) The average rural Medicare Advantage (MA) plan enrollee in 2012 experienced a quality rating of 3.60 stars (of a potential 5.0), compared with a rating of 3.71 stars experienced by urban enrollees. (2) The measured rural-urban difference in the MA plan quality is a result of the difference in the composition of the enrollment and plan availability in MA markets, rather than differences between MA plans of the same type. (a) In general, rural Medicare beneficiaries often have limited MA plans available from which to choose, and typically have lower quality ratings than urban MA plans. (b) Rural MA beneficiaries are more likely to be enrolled in preferred provider organization (PPO) plans than in health maintenance organization (HMO) plans. (c) PPO plans have lower quality ratings on average than HMO plans. (d) HMO plans had the highest average quality rating at 3.83 and 3.78 stars, respectively, in rural and urban areas. PPO plans had lower quality ratings, at 3.52 and 3.50, respectively. (3) In rural areas, 32% of the MA population is enrolled in a plan with a star rating of 4.0 or higher, and 92% are enrolled in a plan with a star rating of at least 3.0, as contrasted to urban enrollment of 36% and 94% respectively, making these plans eligible for quality based bonus payments. (4) The quality rating of rural MA plans varies significantly across the country, with the highest quality ratings in rural areas in Minnesota, Iowa, Wisconsin, Oregon, Pennsylvania, and Maine.
关键数据发现。(1) 2012年农村医疗保险优势（MA）计划的参保者平均质量评级为3.60星（满分5.0星），而城市参保者的评级为3.71星。(2) MA计划质量方面所测得的城乡差异是MA市场中参保构成和计划可获得性差异的结果，而非同一类型MA计划之间的差异。(a) 一般而言，农村医疗保险受益人通常可选择的MA计划有限，且其质量评级通常低于城市MA计划。(b) 农村MA受益人比健康维护组织（HMO）计划更有可能参保优先提供者组织（PPO）计划。(c) PPO计划的平均质量评级低于HMO计划。(d) HMO计划在农村和城市地区的平均质量评级最高，分别为3.83星和3.78星。PPO计划的质量评级较低，分别为3.52星和3.50星。(3) 在农村地区，32%的MA参保人群参保的计划评级为4.0星或更高，92%参保的计划评级至少为3.0星，相比之下，城市参保率分别为36%和94%，这使得这些计划有资格获得基于质量的奖金支付。(4) 农村MA计划的质量评级在全国范围内差异很大，明尼苏达州、爱荷华州、威斯康星州、俄勒冈州、宾夕法尼亚州和缅因州农村地区的质量评级最高。
