Medicaid and CHIP

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2021

  • The Geographic Expansion of Medicaid MCOs
    This project characterized the counties into which Medicaid Managed Care Organizations (MCOs) expanded in 2012-18, focusing on population and provider density, sociodemographics, and health indicators. We assessed the extent to which MCO geographic expansion occurred in compliance with previous network adequacy standards and evaluated how well MCOs were performing in rural areas.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topic: Medicaid and CHIP

2020

2018

2017

  • Assessing the Impact of Medicaid Policy Changes
    Goals of this project included: 1) clearly articulating the rural considerations in Medicare reform by synthesizing information on the impact of Medicare on rural people, places, and providers; 2) assessing the impact of specific proposals to reform Medicare; and 3) analyzing the effects of market-based reform on rural populations, focusing on specific provisions of Medicare reform proposals.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topic: Medicaid and CHIP
  • Rural-Urban Differences in Medicare Service Use and Expenditures in the Last Six Months of Life
    Patterns of end-of-life care are known to vary by rurality and by minority status, and the availability of facilities such as hospice also vary with rurality. This study will examine the relationship between level of service use during the last six months of life and facility availability in county of residence (hospital, SNF, IRF, home health, hospice), as well as minority status of the beneficiary and whether the beneficiary is also eligible for Medicaid ("dual eligible").
    Research center: Rural and Minority Health Research Center
    Topics: Aging, Medicaid and CHIP, Medicare, Minority health
  • State Policy Issues That May Impact HIMs' Success in Rural Places: A Regional Analysis
    Goals of this project include gathering detailed data and providing analysis and policy recommendations on issues relating to network adequacy and service areas for HIMs, with additional investigation of other state-level policy variables (such as the Medicaid expansion decision) which may have a confounding or moderating effect on the relationship between network adequacy and enrollees' choices and premiums.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health information technology, Legislation and regulation, Medicaid and CHIP, Private health insurance, Telehealth
  • Use of Telehealth Services Among Rural Medicaid Enrollees: A Baseline Inventory
    The goal of this project was to generate a multi-state, baseline description of telehealth services provided to Medicaid enrollees in rural and urban settings.
    Research center: Rural Telehealth Research Center
    Topics: Medicaid and CHIP, Telehealth

2016

  • How Have Changes in Insurance Coverage Under Health Reform Affected Uncompensated Care and Financial Performance in Rural Hospitals? (Year 2)
    The second year of this two-year project will explore the effects of changes in insurance coverage under health reform on the following outcomes in rural hospitals: (1) bad debt; (2) charity care; (3) payer mix (Medicare, Medicaid, other); and (4) financial performance.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Healthcare financing, Medicaid and CHIP, Medicare, Private health insurance, Uninsured and underinsured
  • Policy Analysis Using the Financial Distress Model: Does Medicaid Expansion Affect the Risk of Hospital Financial Distress and Closure?
    This study will build on the 2014-15 approved project entitled "Can a Model Predict Financial Distress among Rural Hospitals?" The newly developed model uses current financial performance and market characteristic data to assign rural hospitals to one of four categories of risk of financial distress. The study will use Medicare Cost Report data for 2014, if available. Otherwise, simulation will be used to estimate the effects on financial distress.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicaid and CHIP
  • Rural Health Clinics: Medicare & Medicaid Profile (Year 2)
    Year 2 of a project developing a longitudinal data collection/tracking mechanism of key RHC Medicare claims data and cost report elements. RHC Medicaid data for a sample of states also will be requested and analyzed to determine utilization patterns and identification of potential quality metrics.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Medicaid and CHIP, Medicare, Rural Health Clinics (RHCs)

2015

  • Affordable Care Act Outreach and Enrollment: Case Studies of Rural Hospitals in Four States
    The purpose of this project is to identify best practices used by rural hospitals to educate uninsured rural patients and consumers about available health insurance coverage options and to assist them in enrolling in a Qualified Health Plan or Medicaid.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Medicaid and CHIP, Uninsured and underinsured
  • Early Rural Experiences of Changes to Medicaid
    This project will 1) develop baseline state-level snapshots of rural enrollment in Medicaid and 2) estimate and model enrollment expansion in each state. We will also conduct a baseline provider key informant interviews in late 2013 to gauge expected effects, with follow up interviews in Summer 2014 as a sentinel warning system of early effects of changes to Medicaid in order to inform timely policy development.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Federally Qualified Health Centers (FQHCs), Hospitals and clinics, Medicaid and CHIP

2014

  • Characteristics and Utilization Patterns of Rural Dual-eligible Medicare Beneficiaries
    Persons who are eligible for both Medicare and Medicaid insurance coverage (dual eligible) represent 21% of total Medicare enrollment, but account for more than 36% of Medicare expenditures. The purpose of this study is to ascertain whether dual-eligible beneficiaries living in rural areas differ from their urban counterparts in demographic characteristics and Medicare expenditures.
    Research center: Rural and Minority Health Research Center
    Topics: Cancer, Diabetes, Medicaid and CHIP, Medicare
  • Early Rural Experiences of Changes to Medicaid: Year 1
    In January 2014, some states will expand eligibility through the Medicaid program, while other states will not. Because rural residents are likely to be disproportionately affected by Medicaid expansion, understanding this interstate variation has important policy implications.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Medicaid and CHIP
  • Health Insurance Stability Among Rural Children Following Public Coverage Expansions
    While estimates indicate that the uninsured rate among rural children has dramatically decreased since the 1997 passage of the State Children's Health Insurance Program (CHIP), it is not clear whether or not coverage has become more stable and uninsured spells shorter. The purpose of this study is to investigate changes in insurance stability among rural and urban children following CHIP, and whether this is affected by specific state eligibility and enrollment policies or clusters of policies. Using the 1996, 2001, and 2004 panels of the Survey of Income and Program Participation (SIPP), we will measure rural-urban differences in uninsured spell length and frequency, sources of coverage before and after uninsured spells, movement between sources of coverage, how these measures of stability have changed over time, and the factors that relate to greater continuity of coverage among rural children.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Medicaid and CHIP, Uninsured and underinsured
  • Rural Residential Care: The Implications of Federal and State Policy Changes
    This project will assess the impact on Medicaid-funded rural residential care options of new and proposed federal policy guiding state compliance with the Americans with Disabilities Act (ADA). The extent to which rural facilities are able to comply with the proposed guidelines may affect their eligibility for funding through Home and Community-Based Services waiver programs.
    Research center: Maine Rural Health Research Center
    Topics: Aging, Disabilities, Medicaid and CHIP

2012

2010

  • Medicaid and SCHIP Participation in Rural and Urban Areas
    This project examines state-level Medicaid and SCHIP participation rates for children in rural and urban areas. It also updates the State Profiles of Medicaid and SCHIP in Rural and Urban Areas web site and documents changes in program characteristics relevant to rural areas over the past few years.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Medicaid and CHIP
  • Rural Medicaid and CHIP Mini-Studies
    Medicaid and the Children's Health Insurance Program (CHIP) are important sources of health insurance coverage in rural communities and 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 is composed of three mini-studies that: 1) Update 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.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Children and adolescents, Medicaid and CHIP

2008

  • Assessing the Impact of Transfer of Pharmacy Services for Dual Eligible Beneficiaries to Medicare Part D
    This project will focus on the implementation of the new Part D benefit for those dually eligible for Medicare and Medicaid. The study will examine the impact on rural dual eligibles and their local pharmacies of the transfer to Part D coverage. The project is a joint undertaking with the RUPRI Center, taking advantage of unique data sets held at each center, the analytical and programming resources of both centers, and the ability to conduct qualitative analysis in multiple states efficiently.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Medicaid and CHIP, Medicare Part D, Pharmacy and prescription drugs

2007

  • National Study of Rural Medicaid Disease Management
    This project will identify those states with Medicaid disease management (DM) programs that serve clients in rural areas; analyze the characteristics of the rural DM programs, and identify benefits, challenges and issues for Medicaid programs providing DM services in rural areas.
    Research center: FORHP-funded Individual Grantees
    Topics: Chronic diseases and conditions, Medicaid and CHIP
  • State Facts about Medicaid: Rural Specific Data
    This project will develop state-specific fact sheets which will include information on the groups covered (and income eligibility), structure of the state's SCHIP program, services covered, delivery system, some provider payment information for certain safety net providers, and percentage of the state's rural and urban population that are enrolled in Medicaid. Additional information comparing urban and rural areas of the state will be provided, when available. The rural and urban comparisons will include total numbers of Medicaid recipients, Medicaid expenditures, and enrollment in different types of managed care plans.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Medicaid and CHIP, Rural statistics and demographics

2005

  • Access to Health Care for Young Rural Medicaid Beneficiaries
    This study examined access to health care among rural children ages 0-17 who are enrolled in some type of Medicaid managed care program, and will compare this access across types of programs and, within program type, to that of urban beneficiaries.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Children and adolescents, Health services, Medicaid and CHIP, Oral health, Transportation
  • Impact of The Medicaid Budget Crisis on Rural Communities: A 50-State Survey
    The impact of the Medicaid budgetary crisis on rural communities across the US will be assessed through a 50-state survey of state Medicaid agencies, state Offices of Rural Health and state rural health associations.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Medicaid and CHIP
  • Medicaid Budget Cuts: Effects on Rural Nursing Homes and Rural Elderly and Disabled
    This project will investigate whether nursing home quality and access to nursing home care have eroded in rural areas as a result of changes in Medicare payments or reductions in Medicaid nursing home payments from 2000-2003.
    Research center: Southwest Rural Health Research Center
    Topics: Aging, Disabilities, Long-term care, Medicaid and CHIP

2004

2003

2002

2001

1999