Rural Health
Resources by Topic: Medicaid

Innovations in Rural Health System Development: Moving Rural Health Systems to Value-Based Payment
Offers examples of rural health system transformation models and strategies from Maine and other regions of the U.S. to assist rural communities in moving forward with value-based payment systems.
Author(s): Sara Kahn-Troster, Andrew Coburn
Date: 10/2016
Type: Document
Sponsoring organizations: Maine Health Access Foundation, Maine Rural Health Research Center
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Medicaid Expansion Affects Rural and Urban Hospitals Differently
Examines the impact of Medicaid expansion on urban and rural hospitals. Details specific effects of Medicaid expansion on Medicaid-covered hospital discharges, costs of uncompensated care, and operating margins. Provides policy recommendations regarding uncompensated care and Medicaid disproportionate share hospital (DSH) payments.
Author(s): Brystana G. Kaufman, Kristin L. Reiter, George H. Pink, George M. Holmes
Citation: Health Affairs, 35(9), 1665-1672
Date: 09/2016
Type: Document
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Findings from the Field: Medicaid Delivery Systems and Access to Care in Four States in Year Three of the ACA
Explores the experiences of four states that participated in Medicaid expansion as part of the Patient Protection and Affordable Care Act (ACA): Colorado, Connecticut, Kentucky, and Washington. Examines what each state is doing to transition, from outreach and enrollment activities, to improving delivery systems and access to care. Contains rural-specific content and information on how the states are dealing with the expanded Medicaid population. Addresses how Community Health Centers have responded to the Medicaid expansion.
Author(s): Samantha Artiga, Robin Rudowitz, Jennifer Tolbert, Julia Paradise, Melissa Majerol
Date: 09/2016
Type: Document
Sponsoring organization: KFF
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Oklahoma Emergency Department Utilization: July 2012 through June 2015
Reports on emergency department use in Oklahoma to help guide the state's Medicaid program, SoonerCare. Includes rural/urban breakdowns and some discussion of rural challenges.
Author(s): Mercer Government Human Services Consulting
Date: 08/2016
Type: Document
Sponsoring organization: Oklahoma Health Care Authority
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Two Annual Report
Second annual report detailing the findings of CMS's State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Vermont, and Oregon - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Presents results from the second of three planned site visits to the states, including interviews, focus groups, and surveys. Connections made throughout to issues specifically affecting rural healthcare.
Date: 08/2016
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Project ECHO's Complex Care Initiative: Building Capacity to Help "Superutilizers" in Underserved Communities
Describes a case study from the University of New Mexico's Project ECHO (Extension for Community Health Outcomes) program, which uses telehealth to support primary care clinicians in underserved areas. Focuses on a project targeting Medicaid beneficiaries with substance abuse and mental health issues, with details on two primary care teams being supported, including one in a rural New Mexico community.
Author(s): Martha Hostetter, Sarah Klein, Douglas McCarthy
Date: 08/2016
Type: Document
Sponsoring organization: Commonwealth Fund
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Medicaid Outpatient Payment Policy
Provides an overview of Medicaid payment policies for outpatient hospital services. Attached Excel sheet includes details for each state, including adjustments for rural geography and for Critical Access Hospitals.
Additional links: State Medicaid Payment Policies for Outpatient Hospital Services
Date: 07/2016
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Medicaid Disenrollment Patterns Among Children Coming into Contact with Child Welfare Agencies
Analyzes Medicaid claims from 36 states over a 4-year period to assess retention of health insurance coverage for children involved with the child welfare system. Identifies associations between insurance loss and sociodemographic factors, such as age, race/ethnicity, rural versus urban residence, and other factors.
Author(s): Ramesh Raghavan, Benjamin Allaire, Derek Brown, Raven Ross
Citation: Maternal and Child Health Journal, 20(6), 1280-1287
Date: 06/2016
Type: Document
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Medicaid Payment and Delivery System Reform: Challenges and Opportunities for Rural Health Systems
An analysis of the impact of the Affordable Care Act (ACA) on rural Medicaid programs across the U.S. Examines their acceptance of alternate payment models and their applications of delivery system reform. Provides policy recommendations supporting integrated and comprehensive primary care delivery and rural participation in value-based payment and delivery system reforms.
Additional links: Policy Brief
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 06/2016
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Are Rural Older Adults Benefiting from Increased State Spending on Medicaid Home and Community-Based Services?
Discusses the availability and use of home and community-based services (HCBS) by rural and urban elderly receiving Medicaid funding for long-term services and supports (LTSS) using national Medicaid Analytical Extract claims data.
Author(s): Andrew F. Coburn, Eileen Griffin, Deborah Thayer, Zachariah T. Croll, Erika C. Ziller
Date: 06/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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