Rural enrollment in Medicare Advantage growing rapidly in 2007, especially in private fee-for-service plans.

UNLABELLED: Enrollment in Medicare Advantage (MA) plans has more than tripled since the inception of the MA program at the beginning of 2006. However, rural enrollment remains well below urban enrollment as a percentage of the eligible population. This policy brief provides findings about enrollment in the newly designed MA program in rural and urban areas across the United States and updates early findings from analysis of the Medicare+Choice/ MA program presented in previous RUPRI Center policy briefs. KEY FINDINGS: As of June 5, 2007 (date of release by CMS), (1) Over 780,000 rural Medicare beneficiaries were enrolled in an MA plan, an increase of 50% since November 2006, and a 222% increase since 2005. (2) Despite significant growth in MA plans, only 8.6% of rural persons were enrolled in MA plans in June 2007, compared to 21.7% of urban persons. (3) Over half (55%) of rural persons enrolled in MA or prepaid plans were in private fee-for-service (PFFS) plans, compared to only 14% of urban persons. (4) PFFS enrollment in rural areas in June 2007 was concentrated in several PFFS plans, with almost 90% of rural persons enrolled in plans run by seven organizations serving about 2,000 counties in the United States.

Factors influencing organ donation decisions by African Americans: a review of the literature.

The purpose of this article is to review the literature from 1980 to 2005 regarding organ donation decision making by African Americans for themselves and their loved ones and recommend improvements in subsequent studies. Using the behavioral model of health services utilization as an organizing framework, the review procedure consists of a (1) search of health and medical literature using several key words and eight indexes, (2) selection of articles based on specific criteria, and (3) review of each article with regard to the population and sample used, study design, dependent variables addressed, and its findings. The review indicates that predisposing, enabling, and need factors each influence African Americans' organ donation decision making. Retrospective chart reviews provide a good design for future multivariate analyses of the many factors influencing African American decision making. Interventions to influence decision making should emphasize both community education and the process of organ procurement.

Rural enrollment in Medicare advantage is concentrated in private fee-for-service plans.

Enrollment in Medicare Advantage (MA) plans more than doubled in rural areas in 2006, the first year of the MA program. However, rural enrollment remains well below urban enrollment as a percentage of the eligible population. This policy brief provides findings about enrollment in the newly designed MA program in rural and urban areas across the United States and updates previous findings published in RUPRI Center policy briefs. Analysis of rural-urban differences in costs to beneficiaries that compares type of plan will be released in a policy brief in June 2007.

Enrollment in Medicare Part D for rural beneficiaries is encouraging.

This policy brief provides findings about Medicare beneficiary enrollment in prescription drug plans (PDPs) in rural and urban areas across the United States, updating early findings from an analysis of plans presented in a previous RUPRI Center policy brief (PB2006-8).

Medicare Part D: early findings on enrollment and choices for rural beneficiaries.

On January 1, 2006, the Medicare program began offering prescription drug coverage (Medicare Part D) to over 42 million Medicare beneficiaries. This policy brief provides a first snapshot of enrollment in rural and urban areas across the United States and outlines the early findings from an analysis of plans available to rural persons under Medicare's Part D program. The data in this brief will be updated as new data are available from the Centers for Medicare and Medicaid Services (CMS). Key Findings As of March 18, 2006 (date of release by CMS), (1) 59% of rural beneficiaries and 67% of urban beneficiaries have creditable drug coverage. (2) 21% of rural beneficiaries were enrolled in stand-alone prescription drug plans (PDPs), compared to 13% of urban beneficiaries. (3) 3% of rural beneficiaries were enrolled in Medicare Advantage prescription drug (MA-PD) plans, compared to 16% of urban beneficiaries. (4) In non-adjacent rural areas, 22% of rural beneficiaries were enrolled in stand-alone PDPs, and 2% were enrolled in MA-PD plans. (5) All beneficiaries, including those in rural areas, can choose a PDP option that covers 91% of the top 100 formulary drugs. (6) Average monthly premiums and other plan characteristics for MA-PD plans vary significantly across states-for example (excluding Maine), 2 premiums vary from $6 in urban New Hampshire to $53 in rural Hawaii.