Medicaid and S-CHIP

Publications

Listed by publication date. You can also view these publications alphabetically.

2007

• State Profiles of Medicaid and SCHIP in Rural and Urban Areas
  Author(s): Jennifer King, Leslie Geiger, Pam Silberman, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Medicaid and S-CHIP, Rural statistics and demographics
  Report Number: Final Report No. 91
  Date: 08 / 2007
  This final report is one component of a larger project that includes the development of web-based State Profiles of Medicaid and SCHIP in Rural and Urban Areas. The report provides national data comparing Medicaid enrollment and expenditures in rural and urban counties. A summary of these and other data found in the State Profiles is included.

2006

• Premium Assistance Programs for Low Income Families: How Well Does it Work in Rural Areas?
  Author(s): Pam Silberman, Laura Brogan, Charity Moore, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP, Poverty
  Report Number: Working Paper No. 85
  Date: 01 / 2006
  Reports results of a study on the viability in rural areas of premium assistance programs use Medicaid or State Children's Health Insurance (SCHIP) funding to subsidize the premium costs of employer-sponsored insurance or private non-group policies for eligible individuals. Because of the characteristics of rural residents and their employment markets, many stand to benefit from premium assistance programs, but there are also reasons to believe that these programs may be less successful in rural communities. Findings form the telephone survey of Medicaid or SCHIP officials in 14 of the 16 states with at least one premium assistance program indicate that premium assistance programs have not lived up to their potential. Enrollment in most of the states' programs has been small, and while positive in concept, these programs have inherent limitations that may preclude more widespread enrollment. Of particular concern is that rural residents are more likely to work for small employers who do not offer health insurance or have higher premiums or less comprehensive benefits. However, with creative program design, premium assistance programs may be a useful tool for states to expand health insurance coverage to the rural uninsured.
• Racial and Ethnic Disparities in Potentially Avoidable Delivery Complications Among Pregnant Medicaid Beneficiaries in South Carolina
  Author(s): Sarah Laditka, James Laditka, Janice C. Probst
  Research center: South Carolina Rural Health Research Center
  Topics: African Americans, Health disparities, Maternal and child health, Medicaid and S-CHIP, Minority health, Women
  Citation: Maternal and Child Health Journal, 10(4), 339-50
  Date: 2006
  Examined access to health care during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity. Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Holding other factors constant, potentially avoidable maternity complications were less common in rural hospitals than in urban hospitals. In rural hospitals, African Americans had notably higher risk for potentially avoidable maternity complications than did non-Hispanic whites. The authors conclude that providers and policymakers should work to reduce the risks of potentially avoidable maternity complications for African American women in rural areas who are insured by Medicaid.

2005

• Rural and Urban Parents Report on Access to Health Care for their Children with Medicaid Managed Care
  Author(s): Victoria Freeman, Rebecca Slifkin, Asheley Skinner, Robert Schwartz
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Children, Medicaid and S-CHIP
  Report Number: Working Paper No. 84
  Date: 12 / 2005
  There has been little previous research on rural beneficiaries' perspectives on access to care under Medicaid managed care. The study reported here considers the perspective of the rural beneficiary in four states in order to broaden understanding of whether Medicaid managed care programs provide acceptable access to health care services. The study examines access to health care among rural children ages 0-17 who are enrolled in either fully capitated (New Mexico and Washington) or primary care case management (PCCM) Medicaid managed care plans (North Carolina and North Dakota), and compares this access to that of urban beneficiaries. Overall, this study finds that parents of children living in the rural areas who are enrolled in a Medicaid managed care program are almost always able to get the medical care they need. Rural children who are Medicaid enrollees have primary care providers, their parents know how to access care when needed after hours, and although rural children sometimes use the ER, they do not rely on that source of care more than urban parents do. Where barriers to medical care are reported, they are often consistent with those barriers reported for rural residents generally, and do not appear to be related to restrictions from managed care programs. Access to dental services remains a substantial problem, not just for children in rural areas, but for all Medicaid enrollees. 2004
• Impact of Medicaid Cuts on Rural Communities
  Author(s): Pam Silberman, Matt Rudolf, Laura Brogan, Stephanie Poley, Rebecca Slifkin, Charity Moore
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Medicaid and S-CHIP, Poverty
  Report Number: Working Paper No. 82
  Date: 08 / 2005
  Medicaid is a critical program in both urban and rural areas, but it is particularly important in rural areas because of high levels of poverty and less access to employer-sponsored insurance. This study assesses the perception of state Medicaid staff and individuals from State Offices of Rural Health (SORH) and Rural Health Associations (RHA) regarding the impact on rural areas of state Medicaid policy changes that occurred between 2002 and 2004. Despite the importance of this program to rural communities, our study suggests that few people are specifically concerned with the unique challenges Medicaid changes may pose to rural communities. This study presents insight to the potential rural impact of Medicaid policy changes, especially those that could adversely affect the ability of rural residents to access services or that might potentially affect the overall rural health infrastructure.
• Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals
  Author(s): Sarah B. Laditka, James N. Laditka, Kevin J. Bennett, Janice C. Probst
  Research center: South Carolina Rural Health Research Center
  Topics: African Americans, Health services, Maternal and child health, Medicaid and S-CHIP, Women
  Citation: Journal of Rural Health, 21(2), 158-66
  Date: 2005
  Examined access to health care during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity. Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Holding other factors constant, potentially avoidable maternity complications were less common in rural hospitals than in urban hospitals. In rural hospitals, African Americans had notably higher risk for potentially avoidable maternity complications than did non-Hispanic whites. The authors conclude that providers and policymakers should work to reduce the risks of potentially avoidable maternity complications for African American women in rural areas who are insured by Medicaid.

2004

• Impact Of Medicaid Managed Care, Race/Ethnicity, and Rural/Urban Residence On Potentially Avoidable Maternity Complications: A Five-State Multi-Level Analysis
  Author(s): Sarah B. Laditka, James N. Laditka, Kevin J. Bennett, Janice C. Probst
  Research center: South Carolina Rural Health Research Center
  Topics: African Americans, Hispanics, Maternal and child health, Medicaid and S-CHIP, Women
  Date: 12 / 2004
  Complications of pregnancy affect the lives of many women and infants. This study examines pregnancy-related complications using Potentially Avoidable Maternity Complications (PAMCs) as an indicator of access. Findings include: 1) Mothers delivering in rural hospitals had lower PAMC risks than those with urban deliveries.; 2) In rural hospitals, African American women had greater PAMC risks than white women.; and 3) In urban hospitals, adjusted PAMC risks were substantially lower for Hispanics and Asians than for whites. Executive summary available online.
• Effects of Medicaid Managed Care and Medicaid Managed Care Penetration On Potentially Avoidable Maternity Complications
  Research center: South Carolina Rural Health Research Center
  Topics: Maternal and child health, Medicaid and S-CHIP
  Date: 2004
  The effects of Medicaid Managed Care on pregnancy-related complications affecting mothers during their delivery hospitalizations were examined using the Potentially Avoidable Maternity Complications (PAMCs) indicator.

2003

• Impact Of The Medicaid Budgetary Crisis On Rural Communities
  Author(s): Pam Silberman, Matthew Rudolf, Cammie D'Alpe, Randy Randolph, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topic: Medicaid and S-CHIP
  Report Number: Working Paper No. 77
  Date: 08 / 2003
  Provides an overview of the Medicaid program and options states have to reduce program costs. Steps states have proposed or taken to reduce Medicaid costs and the potential impact of these changes on rural areas are discussed. The potential impact on rural communities of federal proposals to redesign Medicaid is assessed.
• Design of Enhanced Primary Care Case Management Programs Operating in Rural Communities: Lessons Learned from Three States
  Author(s): Stephanie Poley, Pam Silberman, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topic: Medicaid and S-CHIP
  Date: 03 / 2003
  Discusses state programs that provide enhanced benefits to Medicaid beneficiaries such as enhanced primary care case management (PCCM). Examples from three states: Florida, North Carolina and Oklahoma.
• Innovative Primary Care Case Management Programs Operating in Rural Communities: Case Studies of Three States
  Author(s): Pam Silberman, Stephanie Poley, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topic: Medicaid and S-CHIP
  Report Number: Working Paper No. 76
  Date: 01 / 2003
  Medicaid managed care programs have been continually growing in the past decade, but this system has posed some problems to rural areas. In order to address these problems, some states have developed alternative managed care strategies, including enhanced primary care case management (PCCM). This study examines three states that have implemented PCCM and provides an overview of each program including their strengths and weaknesses. The states studied are Florida, North Carolina, and Oklahoma.
• Demand For Medical Services Among Previously Uninsured Children: The Roles of Race and Rurality
  Research center: South Carolina Rural Health Research Center
  Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP, Minority health
  Date: 2003
  Fact sheet examining the use of medical services over nearly two years among newly insured and continuously insured children, ages six through twelve, in the CHIP and Medicaid programs in South Carolina and West Virginia.

2002

• Tracking Medicaid Managed Care in Rural Communities: A Fifty-State Follow-Up
  Author(s): Pam Silberman, Stephanle Poley, Kerry James, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topic: Medicaid and S-CHIP
  Citation: Health Affairs, 21(4), 255-263
  Date: 08 / 2002
  Updates a 1997 study examining implementation of rural Medicaid managed care programs. Among its findings are that there have been significant state-level changes in the types of programs offered; there has been an overall increase in the percentage of urban and rural counties with Medicaid managed care programs; and SCHIP expansion has had little impact on the operation of fully capitated Medicaid managed care programs in rural areas because the increased number of children covered has not been large enough to affect health plans' participation. Concludes that looking only at the increase in rural Medicaid managed care since 1997 could lead to a false impression. While the number of rural counties with fully capitated programs has increased, states' more recent experiences suggest that health plans are pulling out of rural areas just as they are pulling out of urban ones. States may find it difficult to find commercial HMOs willing to participate in Medicaid managed care at prices that states can afford.

2001

• Medicaid Managed Behavioral Health Programs in Rural Areas (Research and Policy Brief)
  Author(s): David Lambert, John Gale, Donna Bird, David Hartley
  Research center: Maine Rural Health Research Center
  Topics: Medicaid and S-CHIP, Mental health
  Date: 08 / 2001
  Study of which states have implemented Medicaid managed behavioral health (MMBH) programs in rural areas. Describes these programs in terms of Medicaid populations served, program design, and implementation model. Describe the experience of programs regarding access to and coordination of services.
• Rural Government Role in Medicaid Managed Care: The Development of County-Based Purchasing in Minnesota
  Author(s): Astrid Knott, Jon B. Christianson
  Research center: Minnesota Rural Health Research Center
  Topics: Health care financing, Medicaid and S-CHIP
  Report Number: Working Paper No. 35
  Date: 01 / 2001
  Describes the development and implementation in Minnesota of a model for rural county government participation in Medicaid managed care initiatives. The model-called County-Based Purchasing-allows county governments the option of functioning as direct purchasers of health care for the Medicaid beneficiaries in their area, accepting financial risk for service delivery. Concludes that if the model is to be used nationally, several issues must be addressed including, the federal approval process for similar initiatives, the relationship between state and county agencies, and sources of funding.
• Medicaid Managed Behavioral Health in Rural Areas
  Author(s): David Lambert, John Gale, Donna Bird, David Hartley
  Research center: Maine Rural Health Research Center
  Topics: Medicaid and S-CHIP, Mental health
  Report Number: Working Paper No. 24
  Date: 01 / 2001
  Study of which states have implemented Medicaid managed behavioral health (MMBH) programs in rural areas. Describes these programs in terms of Medicaid populations served, program design, and implementation model. Describe the experience of programs regarding access to and coordination of services.
• Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000: Concerns, Legislation, and Next Steps
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health policy, Legislation and regulation, Medicaid and S-CHIP, Medicare
  Date: 01 / 2001
  Overview of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) as it impacts rural health.
• Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
  Author(s): Keith J. Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health policy, Legislation and regulation, Medicaid and S-CHIP, Medicare
  Date: 01 / 2001
  Covers rural health policy, SCHIP Benefit Improvement Plan, and legislation.

1999

• Implementation of the State Children's Health Insurance Program: Outreach, Enrollment, and Provider Participation in Rural Areas (Policy Brief)
  Author(s): Jennifer L. Dunbar, Harvey I. Sloane, Curt D. Mueller
  Research center: Walsh Center for Rural Health Analysis
  Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP, Poverty
  Date: 11 / 1999
  The State Children's Health Insurance Program (CHIP) provides states with an important source of funding for helping low-income, uninsured children overcome financial barriers to medical care. This policy analysis brief assesses CHIP outreach, enrollment, and provider issues in Colorado, Kansas, Oklahoma, Pennsylvania, and West Virginia. For a print copy of publications prior to 2004, please contact the Walsh Center at 301-951-5070.
• Implementation of the State Children's Health Insurance Program: Outreach, Enrollment, and Provider Participation in Rural Areas (Full Report)
  Author(s): Jennifer L. Dunbar, Harvey I. Sloane, Curt D. Mueller
  Research center: Walsh Center for Rural Health Analysis
  Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP, Poverty
  Date: 11 / 1999
  The State Children's Health Insurance Program (CHIP) provides states with an important source of funding for helping low-income, uninsured children overcome financial barriers to medical care. There is considerable interest among federal policy makers and rural advocates that CHIP may be especially important in providing coverage to children living in rural areas. This study qualitatively assesses CHIP outreach, enrollment, and provider issues in Colorado, Kansas, Oklahoma, Pennsylvania, and West Virginia. For a print copy of publications prior to 2004, please contact the Walsh Center at 301-951-5070.

1998

• Anticipating the 1997 State Children's Health Insurance Program: What's Current in Five Rural States?
  Author(s): Jennifer Dunbar, Curt Mueller
  Research center: Walsh Center for Rural Health Analysis
  Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP, Poverty
  Date: 01 / 1998
  This study examines aspects of of existing children's health insurance or health services to low-income, uninsured children. For a print copy of publications prior to 2004, please contact the Walsh Center at 301-951-5070.

Related Topics

These related topics also list publications:

• Children (39 items)
• Health insurance and the uninsured (34 items)