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Member Research & Reports

Member Research & Reports

WashU: Change Policy to Improve Insurance Markets in Rural America

A recent report from Washington University in St. Louis – Brown School Public Health Programs provides a deep look at the history of private health insurance in the rural U.S. and what can be done to overcome longstanding barriers to health-insurance coverage there.

The report from the Rural Health Research & Policy Institute chronicles the challenges for a private-market insurance system in rural areas, where people are more likely to work for small employers that don’t offer coverage as a benefit. The smaller numbers of available patients are an additional downside for insurance companies.

Government-assisted private health insurance programs, including Medicaid managed care, Medicare Advantage and the marketplaces established by the Affordable Care Act, have met with limited success in overcoming those challenges. The report makes several policy recommendations, including enlarging coverage areas and changing payment models to focus on health maintenance and prevention.

“A commitment to transparency, as well as efforts to increase health literacy and health insurance literacy will aid all consumers in shopping and comparing options to help make these government-regulated marketplaces more socially efficient,” said the report’s lead author, Dr. Abigail Barker, research assistant professor at the Brown School. Other contributing authors are members of an expert panel on rural health policy that includes Dr. Timothy McBride, Bernard Becker Professor at the Brown School.

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