Key result
Rural Medicare Advantage linked to ~20% fewer missed wellness visits for cardiometabolic patients versus traditional Medicare.
Why the study?
Medicare Advantage enrollment is growing in rural areas where cardiovascular mortality has worsened, but its impact on health care access and affordability for high-risk cardiovascular populations remains unclear.
Does Medicare Advantage enrollment improve health care access, preventive care, and affordability compared to traditional Medicare in rural adults with cardiometabolic conditions?
Cross-Sectional (n=4,274)
Does Medicare Advantage enrollment improve health care access, preventive care, and affordability compared to traditional Medicare in rural adults with cardiometabolic conditions?
Effect estimate: aRD -13.4% (95% CI -17.0 to -9.8)
Absolute Event Rate: 40.1% vs 50.1%
Rural Medicare Advantage beneficiaries with cardiometabolic conditions have better access to preventive care but face greater affordability challenges compared to those in traditional Medicare.
MA plans linked to higher wellness visit completion; leaves open net benefit versus billing burdens in observational Medicare data.
Background Cardiovascular mortality has worsened among rural adults compared with urban counterparts over recent decades. Medicare Advantage (MA) enrollment is increasing in rural areas, yet its impact on access and affordability for high‐risk cardiovascular populations remains unclear. This study evaluated differences in health care access, preventive care, and affordability barriers between rural adults with cardiometabolic conditions enrolled in MA versus traditional Medicare. Methods A cross‐sectional analysis was performed using 2021 to 2022 Medicare Current Beneficiary Survey data. Multivariable logistic regression was used to estimate adjusted risk differences (aRD) in access, preventive care, and affordability barriers between rural MA and traditional Medicare enrollees, adjusting for sociodemographic characteristics. Results The study included 4274 rural beneficiaries with cardiometabolic conditions (weighted population 16 352 800, 53% women). Compared with traditional Medicare, MA enrollees were significantly less likely to miss an annual wellness visit (40.1% versus 50.1%; aRD, −13.4% [95% CI, −17.0% to −9.8%]) or face barriers to preventive care, such as not having annual cholesterol checks (aRD, −3.2% [95% CI, −5.2% to −1.2%]) and influenza vaccinations (aRD, −4.3% [95% CI, −7.8% to −0.7%]). However, MA beneficiaries were more likely to have problems paying medical bills (12.2% versus 6.9%; aRD, 2.5% [95% CI, 0.4%–4.6%]). Conclusions Rural MA beneficiaries with cardiometabolic conditions experienced fewer barriers to preventive care but reported greater difficulty paying medical bills than those in traditional Medicare. As MA expands in rural America, policies are needed to address affordability challenges while preserving access to preventive services.
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Chiu et al. (2026) conducted a cross-sectional in Cardiometabolic conditions (n=4,274). Medicare Advantage vs. Traditional Medicare was evaluated on Missing an annual wellness visit (aRD -13.4%, 95% CI -17.0 to -9.8). Rural Medicare Advantage enrollees with cardiometabolic conditions missed fewer annual wellness visits than traditional Medicare enrollees (40.1% vs 50.1%; aRD -13.4%, 95% CI -17.0 to -9.8).
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