Medicare beneficiaries in rural areas may face challenges to gaining access to care, particularly if enrolled in Medicare Advantage (MA) plans with limited benefits and restrictive provider networks. These barriers to care may, in turn, increase switching to traditional fee-forservice Medicare among rural MA enrollees. Using 2010–16 Medicare Current Beneficiary Survey data, we found that switching from traditional Medicare to Medicare Advantage was uncommon among enrollees, both rural (1.7 percent) and nonrural (2.2 percent). Switching from Medicare Advantage to traditional Medicare was more common in both settings, especially for rural enrollees (10.5 percent) compared with nonrural enrollees (5.0 percent). The differential was even greater among rural enrollees who were high cost or high need. Of eleven care satisfaction variables we examined, dissatisfaction with care access had the strongest association with switching from Medicare Advantage to traditional Medicare among rural enrollees. Our findings point to the importance of developing policies targeted at improving care access for rural MA enrollees.
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