Health Care Use and Access among Rural and Urban Nonelderly Adult Medicare Beneficiaries

Little is known about the characteristics and health care use of rural residents with disabilities. Using the Medicare Current Beneficiary Survey (2009-2013), we compared access to and use of health services among rural and urban nonelderly Medicare beneficiaries with a disability, and examined their health and functional status along with sociodemographic characteristics. We found that the characteristics of nonelderly Medicare beneficiaries with a disability reflected the differences observed between rural and urban populations overall: rural recipients were more likely than their urban peers to be older, non-Hispanic white, and have a lower level of educational attainment. Although self-reported access to care appeared comparable among rural and urban nonelderly Medicare beneficiaries, rural Medicare beneficiaries with a disability reported generally poorer health status and greater impairment compared to their urban counterparts, and certain subgroups of rural nonelderly Medicare beneficiaries with a disability reported greater challenges accessing care. Policymakers and clinicians should consider opportunities to improve access for individuals made vulnerable by functional status, access to care barriers, and/or poorer financial coverage for care