Medicaid and CHIP

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2022

  • An Insurance Profile of Rural America: Chartbook
    Chartbook
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2022
    Over the past decade, health insurance coverage has changed in major ways in rural areas with shifts towards public and publicly subsidized coverage among the nonelderly – Medicaid, Marketplace plans – and a shift towards Medicare Advantage among those eligible for Medicare. This chartbook describes these trends in detail.
  • Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the US
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 10/2022
    This study used data from the Pregnancy Risk Assessment Monitoring System and looked at receipt of recommended postpartum care content. The study describes variations across health insurance type, rural or urban residence, and race and ethnicity.

2021

2020

2019

2018

  • Patterns of Telehealth Use Among Rural Medicaid Beneficiaries
    Journal Article
    Rural Telehealth Research Center
    Date: 10/2018
    This study uses data from the 2011 Medicaid Analytic eXtract (MAX) to examine the prevalence of telehealth use among rural and urban Medicaid beneficiaries, characteristics of telehealth users, types of telehealth services provided, and diagnoses associated with telehealth use.
  • Medicaid Income Eligibility Transitions Among Rural Adults
    Policy Brief
    Maine Rural Health Research Center
    Date: 08/2018
    The Affordable Care Act allows Medicaid expansion to adults under 65 with income below 138% of poverty. Research suggests income shifts affecting Medicaid eligibility are common, but the rural impact is unclear. This national study examines rural and urban adults' annual income shifts above or below the Medicaid expansion eligibility threshold.
  • The Importance of Rural Hospitals: Transfers and 30-day Readmissions Among Rural Residents and Patients Presenting at Rural Hospitals
    Journal Article
    Rural and Minority Health Research Center
    Date: 07/2018
    This study looked at reasons why transfers and readmissions occurred among Medicare patients who first came to rural hospitals.
  • Insuring Rural America: Health Insurance Challenges and Opportunities
    Policy Brief
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 07/2018
    This brief discusses a series of policy considerations in three main categories: policies related to rural insurance risk, policies related to provider networks, and policies related to rural payment rates and structures.
  • Medicaid Managed Care and the Rural Exception: A Review of Issues and Perspectives from the Field
    Policy Brief
    Rural and Minority Health Research Center
    Date: 05/2018
    To examine the intersection of state Medicaid procedures with rural populations, we conducted a review of Medicaid waivers current as of September 2017. This was supplemented with calls to State Offices of Rural Health (SORHs), state Medicaid offices, and other relevant stakeholders in an attempt to understand the process of waiver development.
  • Characteristics of Rural Medicaid Recipients, 2012, 35 States
    Policy Brief
    Rural and Minority Health Research Center
    Date: 04/2018
    The purpose of this brief is to examine the characteristics of Medicaid enrollees prior to Medicaid expansion in 2014, using enrollment and claims data from the Medicaid Analytic Extract Files. This sample allowed for a detailed examination of Medicaid populations in the pre-Medicaid expansion period.
  • Health Care Utilization Patterns of Rural Medicaid Recipients, 2012, 35 States
    Policy Brief
    Rural and Minority Health Research Center
    Date: 04/2018
    The purpose of this brief is to examine inpatient and other institutional encounters among individuals enrolled in Medicaid prior to expansion in 2014, using enrollment and claims data from the Medicaid Analytic eXtract Files. All Medicaid-covered individuals, institutionalized and living in the community, are included.

2017

  • Distribution of Disproportionate Share Hospital Payments to Rural and Critical Access Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2017
    This policy brief provides information about the potential impact of scheduled changes in Medicaid Disproportionate Share Hospital (DSH) payment on hospitals in 47 states. We expect variation across states, because of differences in state policies allocating DSH payments, as well as geographic variation by census region.
  • Differences in Medicare Service Use in the Last Six Months of Life Among Rural and Urban Dual – Eligible Beneficiaries
    Report
    Rural and Minority Health Research Center
    Date: 08/2017
    In this brief, we compare rural and urban dual-eligible beneficiaries to Medicare-only beneficiaries in their service utilization in the last six months of life. Within rural beneficiaries, we further explore differences associated with race/ethnicity.
  • Rural-Urban Differences in Medicare Service Use in the Last Six Months of Life
    Report
    Rural and Minority Health Research Center
    Date: 08/2017
    This brief focuses on the current status of healthcare use during the last six months of life among Medicare beneficiaries. We used data from a sample of Medicare beneficiary claims to assess whether service utilization differed between rural and urban decedents and across decedents of different race/ethnicity categories.
  • Rural/Urban Analysis on Individual Insurance Market Topics
    Fact Sheet
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2017
    Some special challenges face the development and sustainability of marketplace plans in rural areas. This data release provides some additional detail on some important topics, with particular importance to rural people, places, and providers.
  • Changing Rural and Urban Enrollment in State Medicaid Programs
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2017
    Medicaid enrollment growth in 36 states is analyzed by rural and expansion status, pre- and post-Affordable Care Act (ACA). Enrollment growth was larger in expansion states but did take place in most states, with significant state-level variation in both groups. Metropolitan areas generally had higher growth than micropolitan and rural areas.
  • The Role of Public versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children
    Policy Brief
    Maine Rural Health Research Center
    Date: 01/2017
    Medicaid and CHIP have played a critical role in ensuring access to health coverage among children –particularly rural children. This study examines rural-urban differences in children's access to care, and their families' perceived affordability of that care among those enrolled in Medicaid or CHIP, and those with private insurance plans.

2016

  • Are Rural Older Adults Benefiting from Increased State Spending on Medicaid Home and Community-Based Services?
    Policy Brief
    Maine Rural Health Research Center
    Date: 06/2016
    Little is known about variations in the availability or use of Medicaid Home and Community-Based Services (HCBS) within states, across rural and urban areas. This study used national claims data to examine differences in HCBS use and expenditures among rural and urban older adult Medicaid beneficiaries receiving LTSS.
  • Characteristics of Medicaid Beneficiaries Who Use Rural Health Clinics
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2016
    The RHC role varies by state. While we don't have an understanding of what this looks like for each state, we can see that RHCs are an important provider for Medicaid beneficiaries. One of the most important differences is by age groups. All states tend to cater RHC services toward children, with a minimum of 39% of the RHC population < 18.
  • Identifying Rural Health Clinics in Medicaid Data
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2016
    Identifying Rural Health Clinics (RHCs) in Medicaid claims across states is challenging, but this brief recommends methods for identifying the majority of these claims in four states.

2015

2014

  • How Does Medicaid Expansion Affect Insurance Coverage of Rural Populations?
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2014
    This brief examines how states' decisions on Medicaid expansion are impacting rural areas in the United States. Population estimates, current state expansion status, and state-level insurance estimates were used to answer two main questions—how is expansion affecting rural populations and how would it differ if every state were to expand Medicaid.
  • Health Insurance Coverage of Low-Income Rural Children Increases and is More Continuous Following CHIP Implementation
    Policy Brief
    Maine Rural Health Research Center
    Date: 03/2014
    This study found that following the Children's Health Insurance Program's (CHIP) implementation, health insurance coverage and continuity increased among low-income children, particularly for those living in rural areas. By CHIP's maturity, coverage for rural children improved so much that their uninsured rate dropped below that of urban children.

2013

  • Provision of Uncompensated Care by Rural Hospitals: A Preliminary Look at Medicare Cost Report Worksheet S-10
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2013
    This brief is a preliminary assessment of uncompensated care data quality included in Medicare Cost Report Worksheet S-10 for critical access hospitals and other rural hospitals to identify data quality issue implications for research and policy decisions. Worksheet S-10 data were collected from the Healthcare Cost Reporting Information System.

2012

  • The Current and Future Role and Impact of Medicaid in Rural Health
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 09/2012
    This report outlines and describes the current Medicaid program and its importance to rural America. It also discusses rural implications of program expansion, including whether and how states choose to implement changes.

2010

2009

2007

  • State Profiles of Medicaid and SCHIP in Rural and Urban Areas
    North Carolina Rural Health Research and Policy Analysis Center
    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.

2006

2005

2004

2003

2002

2001

1999

1998