Access to healthcare is a basic right, regardless of where a person lives. However, people in rural areas face a unique challenge in accessing quality healthcare due to the low population density, inadequate infrastructure, and limited resources. At the same time, traditional Medicare programs may not be enough to serve the healthcare needs of rural communities. In recent years, Medicare Advantage has emerged as a possible solution to help rural residents access affordable, high-quality healthcare. In this article, we will explore the benefits of Medicare Advantage for rural healthcare and the potential improvements by 2024 https://www.medicareadvantageplans2024.org/
Medicare Advantage plans enable people enrolled in traditional Medicare to opt for a private health insurance plan, which covers all Medicare services and some additional benefits. Medicare Advantage plans were first introduced in 1997, and since then, the number of people enrolled in MA plans has increased steadily across the US.
In contrast, rural residents are less likely to enroll in MA plans due to limited access to providers and lack of awareness of the benefits. However, rural healthcare providers are increasingly partnering with MA companies to offer more comprehensive care to their patients. Some of the benefits of MA plans include lower out-of-pocket costs, additional benefits like dental and vision care, and access to a broader network of healthcare providers. Furthermore, MA plans are more likely to offer value-based care models that align the incentives of doctors and hospitals to improve patient outcomes, rather than just providing fee-for-service payments.
Moreover, there are several other federal programs to support rural healthcare. The Rural Health Clinic (RHC) program helps rural residents get access to primary care, behavioral health, and chronic disease management. The Frontier Extended Stay Clinic (FESC) program focuses on increasing primary care access in frontier areas, where there are fewer than six people per square mile. The Centers for Medicare and Medicaid Services (CMS) also launched the Accountable Health Communities (AHC) model in 2017, a five-year program designed to address the health-related social needs of Medicare and Medicaid beneficiaries in rural and urban areas.
Besides these federal programs, Medicare Advantage is also exploring new tools and technologies to better serve rural communities. For example, telemedicine services can connect rural residents with medical professionals in urban areas, enabling faster access and more personalized care. Mobile clinics can bring healthcare services to remote areas, setting up temporary medical facilities for screenings, vaccinations, and wellness checks. These innovative solutions can help overcome the infrastructure challenges of rural healthcare and provide affordable, quality care to those in need.
By 2024, Medicare Advantage plans could take further steps to optimize rural healthcare. In April 2021, the CMS announced new guidelines for MA plans to expand telehealth services for beneficiaries in remote areas. The new guidelines encourage MA plans to offer more virtual care options for mental health, substance use disorder, and chronic disease management. This expansion of telemedicine could help rural residents stay healthy, reduce transportation costs, and increase access to medical specialists.
In addition, the CMS has proposed changes to the Network Adequacy (NA) standards to ensure that MA plans can provide better access to healthcare providers in underserved and rural areas. The proposed changes include adding a new set of geographic regions to take into account the unique needs of rural healthcare, increasing the number of required specialists and primary care providers in key areas, and making it easier for MA plans to contract with out-of-network providers in a limited capacity. These changes, when implemented, can further improve the quality of care rural residents receive.
Access to healthcare is a fundamental right, and rural residents deserve to receive the same quality of care as urban residents. Medicare Advantage is a promising solution to improve the accessibility and affordability of healthcare services in rural areas. In addition, Medicare Advantage plans can work with federal programs, telemedicine, and innovative technology to address the challenges of rural healthcare and provide quality care to all. With the proposed expansion of telehealth services and changes to the Network Adequacy standards, rural residents can expect to see real improvements in their healthcare coverage by 2024. It is critical to continue investing in and optimizing rural healthcare to ensure everyone is healthy and thriving, regardless of where they live.