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Rural Medicaid and CHIP Mini-Studies

Funder: Office of Rural Health Policy (ORHP)
Research center: North Carolina Rural Health Research and Policy Analysis Center
Phone: 919.966.5541
Lead researcher: Rebecca T. Slifkin, PhD
Contact: Rebecca T. Slifkin, PhD
Project funded: September 2009
Project completed:December 2010
Topics: Children
Medicaid and S-CHIP

Medicaid and the Children's Health Insurance Program (CHIP) are important sources of health insurance coverage, especially in rural communities. In 2007, we created a website with state-level Medicaid enrollment data in rural and urban areas and other rural-relevant program data. Preliminary results from our current study using these data indicate that Medicaid/CHIP participation rates are slightly higher in rural areas nationally, but that rural-urban participation rates vary by state. It is likely that the importance of Medicaid/CHIP will grow as job-based health insurance coverage continues to erode and policymakers pursue the goal of expanding coverage.

This project has three mini-studies that: 1) Update and maintain our State Profiles of Medicaid and CHIP in Rural and Urban Areas website, adding information on Medicaid Disproportionate Share Hospital (DSH) payments to rural hospitals; 2) Analyze trends in Medicaid/CHIP enrollment in rural and urban areas over the past two to three years; and 3) Explore the future role of CHIP given increasing levels of childhood poverty. Publications will include the updated website, a Final Report, and a journal article about barriers to participation.

Publications

  • Recent Changes in Health Insurance Coverage in Rural and Urban Areas
    Author(s): Jennifer King, George M. Holmes
    Date: 05 / 2011
    This findings brief compares changes in health insurance coverage for non-elderly Americans in rural areas to changes in urban areas during the recent economic recession.
  • States' Use of Cost-Based Reimbursement for Medicaid Services at Critical Access Hospitals
    Author(s): Andrea Radford, Mike Hamon, Caitlin Nelligan
    Date: 04 / 2010
    Critical Access Hospitals (CAH) are reimbursed by Medicare at 101% of allowable cost for both inpatient and outpatient services. State Medicaid agencies however are not required to reimburse CAHs on a cost-basis and have flexibility in determining how CAHs are paid for providing services to Medicaid enrollees. This brief documents which states utilize a cost-based reimbursement methodology for Medicaid.