Medicaid and CHIP

Completed Projects

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

2024

• How are Rural Health Clinics Serving Pediatric and Obstetrical Medicaid Populations?
  This project examined the roles of independent and provider-based Rural Health Clinics in serving pediatric and obstetrical patients covered by state Medicaid programs.
  Research center: Maine Rural Health Research Center
  Topics: Children and adolescents, Health services, Healthcare financing, Maternal health, Medicaid and CHIP, Rural Health Clinics (RHCs), Women
  

2023

• Rural/Urban Differences in Postpartum Health Insurance, Healthcare Use, and Health Outcomes
  The purpose of this project was to identify rural/urban differences in health insurance, healthcare use, and health outcomes among postpartum individuals, and to describe policy-relevant implications or strategies to improve insurance coverage, receipt of recommended healthcare, and, ultimately, health outcomes among rural residents who give birth. With a lens towards health equity, all analyses were stratified by race/ethnicity and income.
  Research center: University of Minnesota Rural Health Research Center
  Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Healthcare financing, Hispanics, Hospitals and clinics, Legislation and regulation, Maternal health, Medicaid and CHIP, Minority health, Private health insurance, Women
  

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

• Rates of Telemental Health Use Among Rural Medicaid Enrollees: Associations with Telehealth Policy and Mental Health Access
  This study examined telemental health use among rural and urban Medicaid beneficiaries with mental illness. The goals were to: 1) compare rates and patterns of telemental health; 2) assess how use rates are associated with state-level Medicaid telehealth policies; and 3) determine the extent to which telemental health provides access to care.
  Research center: Rural Telehealth Research Center
  Topics: Medicaid and CHIP, Mental and behavioral health, Telehealth
  

2018

• Characteristics and Utilization Patterns of Rural Medicaid Recipients
  This study used the Medicaid Analytic Extract file to examine the characteristics of persons enrolled in Medicaid by type of eligibility. The study also examined overall utilization and total payments for this utilization. All estimates were subset by rurality and region.
  Research center: Rural and Minority Health Research Center
  Topics: Medicaid and CHIP, Rural statistics and demographics
  
• Eligibility Transitions under the Affordable Care Act: Policy Considerations for Ensuring Coverage Continuity Among Rural Residents
  This study assessed rural versus urban income volatility, the potential effects on states' efforts to ensure continuous health insurance coverage to individuals enrolled in Medicaid expansions or Exchange plans under the Affordable Care Act, and developed policy recommendations to address any observed differences.
  Research center: Maine Rural Health Research Center
  Topics: Medicaid and CHIP, Uninsured and underinsured
  
• For Amber "Waives" of Grain: The Impact of Medicaid Managed Care Waiver Programs on Care Choices in Rural America
  This project used a combination of systematic review of waiver content and structured interviews with key informants to assess the potential for rural disparities in access to care for Medicaid enrollees.
  Research center: Rural and Minority Health Research Center
  Topics: Health disparities and health equity, Medicaid and CHIP
  
• Health Insurance Marketplaces, Medicaid, and Uncompensated Care: The Rural Impact
  This project provides an in-depth analysis of Health Insurance Marketplace (HIM) plan design, specifically measuring the availability and prevalence of high-deductible plans in rural as compared to urban areas.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Health disparities and health equity, Healthcare access, Medicaid and CHIP, Uninsured and underinsured
  

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

• Analysis of State Dental Hygiene Practice Acts and Medicaid Policies for Children's Dental Care: Services Covered and Practitioners Reimbursed
  The purpose of this qualitative analysis will be to obtain a clear picture of the degree to which (1) state SCHIP and Medicaid programs are implementing waivers, or other programs, to improve access to dental care for vulnerable populations including children and pregnant women; and (2) dental hygienists impact the dental safety net for rural America.
  Research center: Rural and Minority Health Research Center
  Topics: Children and adolescents, Health disparities and health equity, Maternal health, Medicaid and CHIP, Oral health
  
• Analysis of the Effects of Federal Debt Reduction and Long Term Budget Adjustment on Rural Health Care Delivery
  The RUPRI Center for Rural Health Policy Analysis will examine suggested changes in Medicare and Medicaid as stated in proposals to reduce spending as part of achieving deficit reduction.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Health services, Medicaid and CHIP, Medicare
  

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

• Analytic Capacity to Respond to Changes in Medicare and Medicaid, Data Assistance to Policy Staff at the Federal Office of Rural Health Policy, and Production of Short Policy Briefs
  This project will produce short policy briefs on a variety of topics related to proposed and enacted changes in Medicare and Medicaid, as requested by policy staff at the federal Office of Rural Health Policy.
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Legislation and regulation, Medicaid and CHIP, Medicare
  
• Chronic Disease Management in Rural Areas: Examination of Medicare and Medicaid Managed Care Programs
  The goal of this project was to advance knowledge of the use of disease management (DM) to address chronic conditions among rural populations, analyzing information from participating health plans and providers about special challenges and effective strategies in DM initiatives targeting rural populations.
  Research center: Southwest Rural Health Research Center
  Topics: Chronic diseases and conditions, Medicaid and CHIP, Medicare
  
• Impact of Medicaid Managed Care, Race/Ethnicity, and Rural/Urban Residence on Avoidable Maternity Complications: A Five-State Multi-level Analysis
  This project will examine differences in access to care for pregnant women enrolled in Medicaid Managed Care (MMC) and Medicaid fee-for-service, and examine differences in the impact of MMC on access among rural and minority persons.
  Research center: Rural and Minority Health Research Center
  Topics: Maternal health, Medicaid and CHIP, Minority health, Women
  
• Medicaid Budget Cuts and Long-Term Care Supplement
  Data on each state will be collected identifying all the changes made to their Medicaid program in the area of long-term care or related services to the frail elderly and disabled, and a policy paper addressing the impact of Medicaid cuts on long term care services, particularly among the elderly in rural areas, will be produced.
  Research center: Southwest Rural Health Research Center
  Topics: Aging, Disabilities, Long-term care, Medicaid and CHIP
  
• State Child Health Insurance Program (S-CHIP) and Access to Medical Transportation Program Services
  This project created a typology of S-CHIP models and the interface between each and the existing Medical Transportation Program (MTP) available to Medicaid recipients in select states. In addition, the project compared rural and non-rural variances in patterns of utilization of MTP service in S-CHIP programs, identified the strengths and weaknesses of the various approaches utilized by the different state MTP models, and compared the performance of the various state models in assuring access to covered medical services and identified barriers to S-CHIP services.
  Research center: Southwest Rural Health Research Center
  Topics: Children and adolescents, Medicaid and CHIP, Transportation
  

2003

• Medicaid Managed Care in Rural Areas: Innovative Case Management Strategies
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Care management, Medicaid and CHIP
  

2002

• Demand for Medical Services Among Previously Uninsured Children: The Role of Rurality
  Research center: Rural and Minority Health Research Center
  Topics: Children and adolescents, Medicaid and CHIP, Uninsured and underinsured
  
• Tracking the Implementation of Medicaid Managed Care in Rural Areas
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topic: Medicaid and CHIP
  

2001

• Locally Managed Behavioral Health Organizations: How Do They Affect The Capacity of Medicaid Managed Behavioral Health Programs to Serve Rural Populations?
  Research center: Maine Rural Health Research Center
  Topics: Medicaid and CHIP, Mental and behavioral health, Networking and collaboration
  

1999

• Medicaid Managed Care in Rural Areas: The Minnesota County-Based Purchasing Program
  Research center: University of Minnesota Rural Health Research Center
  Topic: Medicaid and CHIP
  
• Urban and Rural Differences in Utilization Patterns, Risk Factors and Expenditures of the Dually Eligible Elderly and Non-Elderly Persons with Disabilities
  Research center: Maine Rural Health Research Center
  Topics: Aging, Disabilities, Medicaid and CHIP, Medicare