Rural Medicare Advantage Enrollment--yet another disparity

Recently, Medpac released a statement debunking the thought that up to one-half of all new Medicare enrollees were choosing Advantage plans.  Their analysis indicates that this percentage is only 24%, with 28% of the overall Medicare population enrolled in Advantage plans.

This enrollment is much lower, however, among Rural populations  The RUPRI Center for Rural Health Policy Analysis estimate that less than 18% of rural beneficiaries are enrolled in Advantage plans, a majority of which are actually PPO plans.

Why is this lower percentage significant?  Advantage plans often offer additional benefits (such as dental or vision), care coordination, and lower out of pocket costs for their enrollees.  These benefits do come with a tradeoff in more restrictive networks and services, but it is one often beneficial to the individual.

Rural residents, much like everything else in health care, have a reduced access to Advantage plans.  An insurance industry analysis indicates that rural residents have fewer Advantage options, the premiums are higher, and have fewer benefits than those offered in urban areas.

While this may explain the lower enrollment proportion, it also indicates yet another area in which rural residents may be left behind.