Rural enrollment in Medicare Advantage: growth slows in 2008.

• Overall enrollment in MA plans has nearly doubled since the inception of the program in December 2005, and rural enrollment has quadrupled (Table 1). • But the rate of growth of enrollment in the MA program decreased significantly in 2008, compared to previous years. From January 2008 to December 2008, enrollment in the MA plans and other prepaid plans grew by 12% nationally and 21% in rural areas, compared to an enrollment growth rate of 17% nationally and 35% in rural areas from June 2007 to June 2008. • From January to December 2008, enrollment in PPOs and other types of MA plans grew at a rate of 50% in rural areas and 35% nationally, while PFFS MA plan enrollment grew at a rate of 20% both in rural areas (Table 2) and nationally. • Over half (57%) of rural persons enrolled in MA or other prepaid plans were in MA/PFFS plans in December 2008, compared to only 18% in December 2005 (Figure 1). • HMO/point of service (POS) enrollment in rural areas dropped from 51% to 25% between December 2005 and December 2008 (Figure 1).