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 PDF

  • Tables PDF

  • Summary PDF

  • Acknowledgements

    Acknowledgments PDF

  • Acronyms PDF

  • Chapter 1

    Introduction PDF

  • Chapter 2

    Methods and Data PDF

  • Chapter 3

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

  • Chapter 4

    Payment Trends for Non-Metropolitan Hospitals PDF

  • Chapter 5

    Trends for Rural Health Clinics and Federally Qualified Health Centers PDF

  • Chapter 6

    Utilization and Spending for Physician Services PDF

  • Chapter 7

    1990-1997 Trends in AAPCC Capitation Rates PDF

  • Chapter 8

    Special Hospital Payments and Part a Per Capita Costs PDF

  • Chapter 9

    Policy Implications and Recommendations PDF

  • References PDF

  • Appendix A

    Special Medicare Payments for Rural Hospitals PDF

  • Appendix B

    Definitions of Rurality PDF

The research described in this report was performed under the auspices of RAND Health.

This report is part of the RAND Corporation monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.