Medicaid/CHIP

Publicly-funded programs that cover medical and long-term care for low-income adults, children, and people with disabilities. Medicaid expansion is one of the central tools to increase insurance coverage rates through the Affordable Care Act.

THRIVE: Addressing Patients’ Social Needs after Hospitalization

Jul. 30, 2019

Imagine being discharged from the hospital to a two-room apartment badly in need of repair. Your electricity has been cut off and you can barely remember the discharge instructions. You were told to see a specialist in a week, but it will take you 90 minutes one-way on public transportation to get there. Confused about follow-up and juggling the complexities of life, what do you do?

Primary Care Appointments for Medicaid Beneficiaries With Advanced Practitioners

Jul. 1, 2019

Lena Leszinsky, Molly Candon

Abstract [from journal]

Primary care access in Medicaid improved after the Patient Protection and Affordable Care Act despite millions of new beneficiaries. One possible explanation is that practices are scheduling more appointments with advanced practitioners. To test this theory, we used data from a secret shopper study in which callers simulated new Medicaid patients and requested appointments with 3,742 randomly selected primary care practices in 10 states. Conditional on scheduling an appointment, simulated patients asked whether the practitioner...

Medicaid and Nursing Home Choice: Why Do Duals End Up in Low-Quality Facilities?

Apr. 17, 2019

Hari Sharma, Marcelo Coca Perraillon, Rachel M. Werner, David C. Grabowski, R. Tamara Konetzka

ABSTRACT [FROM JOURNAL]

We provide empirical evidence on the relative importance of specific observable factors that can explain why individuals enrolled in both Medicare and Medicaid (duals) are concentrated in lower quality nursing homes, relative to those not on Medicaid. Descriptive results show that duals are 9.7 percentage points more likely than nonduals to be admitted to a low-quality (1-2 stars) nursing home. Using the Blinder–Oaxaca decomposition approach in a multivariate framework, we find that 35.4% of the difference in admission to low-quality nursing homes can be...

Proposed Work Requirements in Pennsylvania Medicaid: Characterizing Eligible Beneficiaries

Issue Brief
Feb. 8, 2019

To help the Pennsylvania Department of Human Services understand the likely impact of a proposed Medicaid work requirement, we analyzed the demographic, economic and health characteristics of working-age, non-disabled adults who receive Medicaid, and any issues or barriers this population may face in obtaining and maintaining employment.

Strengthening Medicaid Waiver Evaluations

Dec. 3, 2018

States are considered “laboratories of democracy,” allowing experimentation with innovative reforms that could potentially be adopted at the national level. To test new approaches in their Medicaid programs, states have embraced Section 1115 waivers, which permit innovations that do not meet federal program rules, but still promote the program’s objectives.

Transportation and Medicaid: Breaking Through the Gridlock

Nov. 17, 2018

Lack of transportation has been an enduring barrier to care, especially for low-income and rural patients. Many of these patients are covered by Medicaid, which, since 1966, has provided non-emergency transportation (NEMT) to medical appointments for free or at a heavily subsidized rate. Although NEMT is built into the foundation of Medicaid, some state governments are seeking leeway to drop that benefit. The movement stems from persistent budget constraints and a view that NEMT is ineffective.

Supply of Primary Care Providers and Appointment Availability for Philadelphia's Medicaid Population

Issue Brief
Oct. 23, 2018

This brief analyzes the supply of primary care providers serving the Medicaid population in Philadelphia, and the geographic variability of this measure across the city. It also examines important measures of access – appointment availability and wait time for an initial appointment – that highlight challenges faced by Medicaid patients.

Primary Care Access for Philadelphia’s Medicaid Population

Oct. 23, 2018

Following Medicaid expansion in Pennsylvania in 2015, more than one in five non-elderly adults in Philadelphia are now covered by Medicaid. This population faces unique challenges with accessing primary care, including fewer providers accepting Medicaid patients. 

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