Trends in Special Medicare Payments and Service Utilization for Rural Areas in the 1990s

by Donna O. Farley, Lisa R. Shugarman, Pat Taylor, Moira Inkelas, J. Scott Ashwood, Feng Zeng, Katherine M. Harris

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This report analyzes four types of special payments that Medicare has been making to rural hospitals and physicians. These special payments are intended to support the rural health care infrastructure to help ensure access to care for Medicare beneficiaries. The research provides a comprehensive overview of these payments, including documentation of the supply of providers, trends in payments, and Medicare costs per beneficiary.

Table of Contents

  • Preface

  • Tables

  • Summary

  • Acknowledgements

    Acknowledgments

  • Acronyms

  • Chapter 1

    Introduction

  • Chapter 2

    Methods and Data

  • Chapter 3

    Characteristics of U.S. Metropolitan and Non-Metropolitan Counties

  • Chapter 4

    Payment Trends for Non-Metropolitan Hospitals

  • Chapter 5

    Trends for Rural Health Clinics and Federally Qualified Health Centers

  • Chapter 6

    Utilization and Spending for Physician Services

  • Chapter 7

    1990-1997 Trends in AAPCC Capitation Rates

  • Chapter 8

    Special Hospital Payments and Part a Per Capita Costs

  • Chapter 9

    Policy Implications and Recommendations

  • References

  • Appendix A

    Special Medicare Payments for Rural Hospitals

  • Appendix B

    Definitions of Rurality

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