Rural health disparities widen for MA enrollees: 4 takeaways

Health disparities among Medicare Advantage patients in rural areas widened in 2023, a new CMS report shows.

The report, published Nov. 12, examined 2023 data from Medicare Consumer Assessment of Healthcare Providers and Systems surveys and the Healthcare Effectiveness Data and Information Set. In total, seven CAHPS measures and 41 HEDIS measures were included in the analysis. The analysis was funded by CMS and performed by RAND Health Care.

Four takeaways: 

1. Thirty-four percent of HEDIS care measures for Medicare Advantage enrollees in rural areas were below the national average. This figure is up from 21% in 2022, suggesting a growing disparity in care quality for rural enrollees.

2. Care measures with the largest deficits among Medicare Advantage enrollees included:

  • Kidney health evaluation for diabetes patients (15 percentage point difference compared to urban enrollees)
  • Osteoporosis screening in older women (7 percentage point deficit)

3. The trend of urban residents having clinical scores similar to the national average and rural residents having scores below it was consistent across most racial and ethnic groups, except Hispanic Medicare Advantage enrollees. In rural areas, Hispanic enrollees had results below the national average on about 40% of measures (many involving behavioral healthcare) and above the national average for nearly 25% of measures.

4. In five of 10 HEDIS measures included in a 2017-2023 trends analysis, rural enrollees saw more improvement than their urban counterparts. However, rural residents still faced gaps compared to the national average, while urban residents maintained their advantage. 

View the full report here.

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