Jeffrey Stensland, a principal policy analyst at the Medicare Payment Advisory Commission, or MedPAC, in Washington; Adaeze Akamigbo, a former senior policy analyst at MedPAC; David Glass, a principal policy analyst at MedPAC; and Daniel Zabinski, a senior policy analyst at MedPAC, said the conventional wisdom rural beneficiaries systematically receive less care resulted in Congress allocating $3 billion more each year in special payments than they would receive under traditional Medicare payment rates.
The researchers compared the use of medical services between urban and rural areas using claims data from all Medicare fee-for-service beneficiaries in 2008.
They found no significant differences between rural and urban beneficiaries in either the amount of healthcare received or in satisfaction with access to care.
However, the study, published in Health Affairs, found some of these payments might not be necessary -- after adjusting for health status, rural and urban areas in the same region had nearly identical rates of service use.
Although the study found no significant differences between rural and urban beneficiaries in the same region, it did find large differences across both urban and rural areas in different regions.
"The key policy implication of this article is that Medicare should not use rural location as a proxy for low service use or access to care," the study authors reported. "Policies that implicitly assume all rural areas are homogeneous and all rural beneficiaries are underserved are not supported by the data."
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