Cutler Institute for Health and Social Policy

Population Health and Health Policy, Maine Rural Health Research Center

New article in Journal of Rural Health examines network adequacy standards for Qualified Health Plans

Journal of Rural Health cover

The Affordable Care Act (ACA) requires Health Insurance Exchanges (HIEs) to specify network adequacy standards for the Qualified Health Plans (QHPs) they offer to consumers. This article, authored by research staff at the Maine Rural Health Research Center, USM Muskie School, examines rural issues surrounding network adequacy standards, and offers recommendations for crafting standards that optimize rural access.

The authors review ACA requirements for QHP network adequacy standards, considering Medicaid managed care and Medicare Advantage (MA) standards as models, and analyze the implications of stringent vs flexible access standards in terms of how choices might affect health plans' participation in rural markets and rural enrollees' access to care. The authors propose strategies for designing standards with the degree of flexibility most likely to benefit rural consumers, including adjusting standards according to degrees of rurality and rural utilization norms; counting midlevel clinicians toward fulfillment of patient-provider ratios; and allowing plans to ensure rural access through delivery system innovations such as telehealth.

Talbot, J. A., Coburn, A., Croll, Z. and Ziller, E. (2013), Rural Considerations in Establishing Network Adequacy Standards for Qualified Health Plans in State and Regional Health Insurance Exchanges. The Journal of Rural Health. doi: 10.1111/jrh.12012

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Hartley Retires as Director of the Maine Rural Health Research Center

David Hartley, PhD

David Hartley, PhD, the Director of the Maine Rural Health Research Center (MRHRC) and a Research Professor of Public Health has announced that he will be retiring from the University of Southern Maine August 31st, 2014. David came to the University in 1994 and has directed the MRHRC since 2004. Andy Coburn, PhD, Research Professor of Public Health, will take over as the new MRHRC Director. Erika Ziller, PhD continues in her role as Deputy Director. David has had a distinguished career in rural health and rural health research, and has made lasting contributions to the field with his work on rural behavioral health, rural disparities and health, and rural active living.

A celebration will be scheduled in early fall to honor David and his many contributions to the field and the University.

 

Learn More

Hartley Retires as Director of the Maine Rural Health Research Center

David Hartley, PhD

David Hartley, PhD, the Director of the Maine Rural Health Research Center (MRHRC) and a Research Professor of Public Health has announced that he will be retiring from the University of Southern Maine August 31st, 2014. David came to the University in 1994 and has directed the MRHRC since 2004. Andy Coburn, PhD, Research Professor of Public Health, will take over as the new MRHRC Director. Erika Ziller, PhD continues in her role as Deputy Director. David has had a distinguished career in rural health and rural health research, and has made lasting contributions to the field with his work on rural behavioral health, rural disparities and health, and rural active living.

A celebration will be scheduled in early fall to honor David and his many contributions to the field and the University.

 

Learn More

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