News: CMS report details clinical care disparities for rural, urban healthcare

CMS, in collaboration with the Rand Corporation, has released a report detailing the differences between rural and urban healthcare, according to the American Hospital Association (AHA).

The 235-page report, entitled Rural-Urban Disparities in Healthcare in Medicare, is broken up into three distinct sections and examines:

1. Rural-urban differences in health care experiences and clinical care
2. How rural-urban differences in health care experiences and clinical care vary by race and ethnicity
3. Historical trends in quality of care for rural and urban residents

The report utilized two sources of information: the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) and the Healthcare Effectiveness Data and Information Set (HEDIS). According to the appendix of the report, each data set comes with a set of clinical measures that allow for a standardized comparison between the rural and urban settings.

Here are three highlights from the report, one corresponding to each section:

• Rural-urban differences in healthcare experiences and clinical care: Overall, Medicare Advantage (MA) enrollees living in rural areas had results that were below the national average for more than a third of all clinical care measures examined. For example, some of the largest deficits in clinical care for rural residents were in kidney health evaluation for patients with diabetes (a 15 percentage point deficit for MA enrollees living in rural areas), and potential drug-disease interactions in older patients with dementia (an eight percentage point deficit).
• Rural-urban differences in healthcare experiences and clinical care by race and ethnicity: Whereas in urban areas Hispanic MA enrollees had results that were generally similar to the national average for all Hispanic MA enrollees, in rural areas they had results that were below the national average on nearly 40 percent of measures and above the national average on nearly a quarter of measures.
• Historical trends in quality of care for rural and urban residents: For five of the 10 HEDIS measures included in the trend analysis, scores increased for urban and rural residents from Reporting Year 2017 to Reporting Year 2023 but did so more for rural residents than for urban residents. As a result, in all of these cases initial advantages for MA enrollees living in urban areas (relative to the national average) remained about the same while initial gaps for MA enrollees living in rural areas shrank.

Editor’s note: To read the CMS report, click here. To read the brief AHA description, click here.