Rural Children Don\u27t Receive the Mental Health Care They Need

Key Findings: Just over one-third of all children with a mental health problem received a mental health visit in the past year; Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children; Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas

Rural-urban differences in health care access vary across measures

Rural uninsured rates are higher than urban,1 and the uninsured often have difficulty obtaining needed care.2 Difficulties recruiting and retaining health care providers have resulted in longstanding disparities in rural and urban physician supply.3 This combination of factors suggests that rural residents may face greater barriers to accessing health care than their urban counterparts. Analyses of data from the 2006 Medical Expenditure Panel Survey (MEPS) for non-elderly rural and urban residents partly supports this premise, yet rural residents fare better on some measures of access

Implications of rurality and psychiatric status for diabetic care use among adults with diabetes

This research examined patterns of diabetic preventive care use among adults with diabetes, to determine whether these patterns varied according to respondents’ rural/urban residence or psychiatric status (i.e., the presence/absence of a mental health diagnosis). Specifically, we considered whether rural people with diabetes are less likely than urban peers to use diabetic preventive services; whether having a mental health diagnosis affects preventive service use among diabetics; and, whether rural/ urban differences in service use vary depending on the presence or absence of a mental health diagnosis

Profile of rural health insurance coverage: A chartbook

More than twenty years of research has demonstrated that rural residents are at greater risk of being uninsured compared to urban residents and more recent studies point to problems of underinsurance as well. Most studies have shown that the problems of uninsurance and underinsurance are greatest among rural residents living in smaller communities located further from more urbanized areas. Section I examines recent estimates and changes since 1997 in rural health insurance coverage. Section II explores differences in the demographic, socio-economic, employment and other risk factors for uninsurance among rural and urban residents. Section III profiles the demographic and economic characteristics of the rural and urban uninsured. Section IV examines differences in the employment characteristics of the rural and urban uninsured. The final section discusses policy implications for covering the rural uninsured. Methods and an appendix of data tables provide source material for the chartbook

Rural Disabled Medicare Beneficiaries Spend More out-of-Pocket Than Their Urban Counterparts

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 to evaluate rural-urban differences in out-of-pocket spending, supplemental coverage, and variation in spending by type of service. The proportion of total spending paid out-of-pocket is 40% higher among rural disabled Medicare beneficiaries compared to urban disabled beneficiaries. Rural disabled and elderly beneficiaries are more likely to go without any form of supplemental coverage than urban beneficiaries

Maine\u27s Rural Health Challenges

This brief describes the issues affecting access to health care in rural Maine. These issues include Maine’s use of enhanced Medicare and Medicaid payments to support the rural health infrastructure, the adequacy of the provider workforce and the presence of training programs, the contribution of health care to the rural economy, and the high prevalence and unmet need for care for persons with substance use and mental health issues

High Deductible Health Insurance Plans in Rural Areas

Enrollment in high deductible health plans (HDHPs) has increased amid concerns about growing health care costs to patients, employers, and insurers. Prior research indicates that rural individuals are more likely than their urban counterparts to face high out-of-pocket health care costs relative to income, despite coverage through private health insurance, a difference related both to the lower income of rural residents generally and to the quality of the private plans through which they have coverage. Using the 2007-2010 National Health Interview Survey, this study examines rural residents’ enrollment in HDHPs and the implications for evolving Affordable Care Act Health Insurance Marketplaces. Rural residents with private insurance are more likely to have an HDHP than are urban, especially when they live in remote, rural areas. Among those covered by an HDHP, rural residents are more likely to have low incomes and more limited educational attainment than urban residents, suggesting that it will be important to monitor HDHP enrollment, plan affordability, and health plan literacy among plans available through the Health Insurance Marketplaces

Rural residents more likely to be enrolled in high-deductible health plans

Enrollment in high deductible health plans (HDHPs) has increased amid concerns about growing health care costs to patients, employers, and insurers. Prior research indicates that rural individuals are more likely than their urban counterparts to face high out-of-pocket health care costs relative to income, despite coverage through private health insurance, a difference related both to the lower income of rural residents generally and to the quality of the private plans through which they have coverage. Using the 2007-2010 National Health Interview Survey, this study examines rural residents’ enrollment in HDHPs and the implications for evolving Affordable Care Act Health Insurance Marketplaces. Rural residents with private insurance are more likely to have an HDHP than are urban, especially when they live in remote, rural areas. Among those covered by an HDHP, rural residents are more likely to have low incomes and more limited educational attainment than urban residents, suggesting that it will be important to monitor HDHP enrollment, plan affordability, and health plan literacy among plans available through the Health Insurance Marketplaces

Out-of-Pocket Spending among Rural Medicare Beneficiaries

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 to evaluate rural-urban differences in out-of-pocket spending, supplemental coverage, and variation in spending by type of service. The proportion of total spending paid out-of-pocket is 40% higher among rural disabled Medicare beneficiaries compared to urban disabled beneficiaries. Rural disabled and elderly beneficiaries are more likely to go without any form of supplemental coverage than urban beneficiaries