TY - JOUR
T1 - Does the Medicare Part D Decision-Making Experience Differ by Rural/Urban Location?
AU - Henning-Smith, Carrie
AU - Casey, Michelle
AU - Moscovice, Ira
N1 - Publisher Copyright:
© 2016 National Rural Health Association
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Purpose: Although much has been written about Medicare Part D enrollment, much less is known about beneficiaries’ personal experiences with choosing a Part D plan, especially among rural residents. This study sought to address this gap by examining geographic differences in Part D enrollees’ perceptions of the plan decision-making process, including their confidence in their choice, their knowledge about the program, and their satisfaction with available information. Methods: We used data from the 2012 Medicare Current Beneficiary Survey and included adults ages 65 and older who were enrolled in Part D at the time of the survey (n = 3,706). We used ordered logistic regression to model 4 outcomes based on beneficiaries’ perceptions of the Part D decision-making and enrollment process, first accounting only for differences by rurality, then adjusting for sociodemographic, health, and coverage characteristics. Findings: Overall, half of all beneficiaries were not very confident in their Part D knowledge. Rural beneficiaries had lower odds of being confident in the plan they chose and in being satisfied with the amount of information available to them during the decision-making process. After adjusting for all covariates, micropolitan residents continued to have lower odds of being confident in the plan that they chose. Conclusions: Policy-makers should pay particular attention to making information about Part D easily accessible for all beneficiaries and to addressing unique barriers that rural residents have in accessing information while making decisions, such as reduced Internet availability. Furthermore, confidence in the decision-making process may be improved by simplifying the Part D program.
AB - Purpose: Although much has been written about Medicare Part D enrollment, much less is known about beneficiaries’ personal experiences with choosing a Part D plan, especially among rural residents. This study sought to address this gap by examining geographic differences in Part D enrollees’ perceptions of the plan decision-making process, including their confidence in their choice, their knowledge about the program, and their satisfaction with available information. Methods: We used data from the 2012 Medicare Current Beneficiary Survey and included adults ages 65 and older who were enrolled in Part D at the time of the survey (n = 3,706). We used ordered logistic regression to model 4 outcomes based on beneficiaries’ perceptions of the Part D decision-making and enrollment process, first accounting only for differences by rurality, then adjusting for sociodemographic, health, and coverage characteristics. Findings: Overall, half of all beneficiaries were not very confident in their Part D knowledge. Rural beneficiaries had lower odds of being confident in the plan they chose and in being satisfied with the amount of information available to them during the decision-making process. After adjusting for all covariates, micropolitan residents continued to have lower odds of being confident in the plan that they chose. Conclusions: Policy-makers should pay particular attention to making information about Part D easily accessible for all beneficiaries and to addressing unique barriers that rural residents have in accessing information while making decisions, such as reduced Internet availability. Furthermore, confidence in the decision-making process may be improved by simplifying the Part D program.
KW - Medicare
KW - geriatrics
KW - health services research
KW - pharmacy
KW - policy
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U2 - 10.1111/jrh.12175
DO - 10.1111/jrh.12175
M3 - Article
C2 - 26880071
AN - SCOPUS:84959378887
SN - 0890-765X
VL - 33
SP - 12
EP - 20
JO - Journal of Rural Health
JF - Journal of Rural Health
IS - 1
ER -