Medicine and Health Sciences Commons^™

Rural Disabled Medicare Beneficiaries Spend More Out-Of-Pocket Than Their Urban Counterparts, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd

Access / Insurance

The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …

Rural Adults Delay, Forego, And Strategize To Afford Their Pre-Aca Health Care, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd

Access / Insurance

About 40% of non-elderly adults reported problems paying medical bills or cost-related barriers to obtaining needed medical care in 2012, difficulties that are especially pronounced for the uninsured and underinsured, the chronically-ill, and those with low incomes. Given their lower incomes and higher uninsured rates compared to urban residents, rural residents may face particular cost barriers in accessing health care. Past research has shown that, compared to urban residents, rural residents are more likely to experience higher out-of-pocket costs and delayed or foregone care as a result of cost, even when covered by private health insurance. This study provides detailed …

Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd

Access / Insurance

The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …

Maine Ems Community Paramedicine Pilot Program Evaluation, Karen B. Pearson Mlis, Ma, George Shaler Mph

Emergency Medical Services (EMS)

In November 2014, the Muskie School of Public Service at the University of Southern Maine was awarded a contract to evaluate the implementation of the statewide CP Pilot Program in Maine. This report presents process level results from the evaluation. The report includes findings from interviews with the twelve community paramedicine pilot sites in Maine and with the state of Maine EMS office.

The layout of the report follows the key themes and categories from our interviews:

• Staffing
• Training
• Stakeholders and Partners
• CP Services
• CP Event
• Data Collection
• Funding
• Challenges
• Successes
• Sustainability

The report concludes with lessons learned which may …

Promoting Active Living In Rural Communities, Anush Yousefian Hansen Ms, Ma, David Hartley Phd, Mha

Population Health

This brief summarizes current research on elements of the rural built environment that may be related to obesity or physical activity. Much of this research is qualitative in nature, including evidence and conclusions drawn from rural focus groups, PhotoVoice studies, policy statements, observations from the field, and lessons learned from rural active living interventions.

First Steps Phase Iii Initiative: Improving Oral Health And Healthy Weight In Children Final Evaluation Report, Carolyn E. Gray Mph, Kimberley S. Fox Mpa

Population Health & Health Policy

This report summarizes evaluation findings from Phase III and assesses change in oral health and healthy weight screening rates, referrals and related office system procedures in participating practices. The report also highlights challenges encountered and lessons learned in implementing changes to office systems, in responding to state policy changes, and in collecting and tracking oral health and healthy weight measures at the practice-level to inform quality improvement.

Rural Health Clinic Readiness For Patient-Centered Medical Home Recognition: Preparing For The Evolving Healthcare Marketplace [Policy Brief], John A. Gale Ms, Zachariah T. Croll Mph, David Hartley Phd, Mha, Andrew F. Coburn Phd

Rural Health Clinics

The patient-centered medical home (PCMH) model reaffirms traditional primary care values including continuity of care, connection with an identified personal clinician, provision of same day- and after-hours access, and positions providers to participate in accountable care and other financing and delivery system models. However, little is known about the readiness of the over 4,000 Rural Health Clinics (RHCs) to meet the PCMH Recognition standards established by the National Council for Quality Assurance (NCQA). The authors present findings from a survey of RHCs that examined their capacity to meet the NCQA PCMH requirements, and discuss the implications of the findings for …

Rural Health Clinic Readiness For Patient-Centered Medical Home Recognition: Preparing For The Evolving Healthcare Marketplace [Working Paper], John A. Gale Ms, Zachariah T. Croll Mph, David Hartley Phd, Mha

Rural Health Clinics

The patient-centered medical home (PCMH) model reaffirms traditional primary care values including continuity of care, connection with an identified personal clinician, provision of same day- and after-hours access, and positions providers to participate in accountable care and other financing and delivery system models. However, little is known about the readiness of the over 4,000 Rural Health Clinics (RHCs) to meet the PCMH Recognition standards established by the National Council for Quality Assurance (NCQA). The authors present findings from a survey of RHCs that examined their capacity to meet the NCQA PCMH requirements, and discuss the implications of the findings for …