The Impact of Medicaid and SCHIP on Low-Income Children's Health

Reviews the literature on the impact of Medicaid and State Children's Health Insurance Programs on the coverage, access to care, and health outcomes for low-income children, as well as remaining challenges in preventive, primary, and dental care

A Profile of Medicaid Managed Care Programs in 2010: Findings From a 50-State Survey

Examines types of Medicaid managed care organizations and contracts by state, including managed care organizations and primary care case management programs; issues for measuring, monitoring, and improving quality; and implications of health reform

Turning to Medicaid and SCHIP in an Economic Recession: Conversations With Recent Applicants and Enrollees

Based on focus group discussions, examines how the loss of jobs and employer-sponsored health insurance affects families. Explores the limitations of COBRA and private insurance and the role of Medicaid and State Children's Health Insurance Programs

Health Center Trends: Recent Experience in Medicaid Expansion and Non-Expansion States.

In thousands of medically underserved communities across the U.S., community health centers enroll lowincome people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and service capacity, comparing states that implemented the ACA Medicaid expansion in 2014 and states that did not expand Medicaid in 2014. The study is based on 2014 data from the federal Uniform Data System and a 2014 national survey of health centers

Quality of Care in Community Health Centers and Factors Associated With Performance

Federally funded community health centers are a key source of comprehensive primary care for medically underserved communities, serving more than 20 million patients in 2011. The Affordable Care Act (ACA) expanded the health center program significantly to help meet the increased demand for health care that is expected as millions of the uninsured gain health coverage, beginning in 2014. Especially given health centers’ growing role, evidence of the quality of care they provide is of keen interest. Most research shows high performance by health centers relative to various standards, but some gaps have also been found, and suitable benchmarks for assessing the quality of care provided by health centers, which serve a uniquely disadvantaged population, have been lacking. Recently, the Kaiser Commission on Medicaid and the Uninsured (KCMU) partnered with the George Washington University to analyze health center performance relative to Medicaid managed care organizations (MCO), which also serve a low-income population, on important measures of quality of care – diabetes control, blood pressure control, and receipt of a Pap test in the past three years. The study also aimed to identify factors that differ significantly between high-performing and lower-performing health centers. Using data reported in the federal 2010 Uniform Data System (UDS) by health centers and the 2008 Healthcare Effectiveness Data and Information Set (HEDIS) for Medicaid MCOs, we defined health centers as “high-performing” if their rates exceeded the 75th percentile of Medicaid MCO HEDIS scores on all three of our quality measures. We defined health centers as “lower-performing” if their rates were below the mean Medicaid MCO HEDIS score on all three measures

Providing Outreach and Enrollment Assistance: Lessons Learned from Community Health Centers in Massachusetts

In 2006, major health care reform legislation was enacted in Massachusetts. In many ways a prototype for the Affordable Care Act (ACA), the Massachusetts law required nearly all state residents to obtain health insurance, and made insurance accessible and affordable by reforming the health insurance market and providing subsidies for coverage through expansions of Medicaid and CHIP and a new program for low-income adults who are not eligible for Medicaid, known as Commonwealth Care. The law also created the “Connector,” which, like the ACA’s health insurance Marketplaces, is designed to facilitate and simplify access to insurance for individuals, families, and small businesses. In addition, the law established a Health Safety Net (HSN) Fund that finances health care for residents who remain uninsured permanently or on an intermittent basis. Understanding that outreach and enrollment assistance would be essential to the health reform law’s success, Massachusetts policymakers launched high-profile public education campaigns, but they also provided for person-to-person, hands-on assistance, especially in low-income communities with large numbers of uninsured residents, many of whom have no previous experience signing up for insurance subsidies or selecting and enrolling in a health plan. Community health centers – a critical source of comprehensive primary health care and many other services for medically underserved populations and communities in Massachusetts – have played a central role in this outreach and enrollment effort. To help inform current outreach and enrollment efforts associated with the ACA’s coverage expansion, the Kaiser Commission on Medicaid and the Uninsured asked researchers at The George Washington University to examine the enrollment assistance experience of Massachusetts health centers six years into that state’s health reform program. Because of their safety-net role, health centers are uniquely aware of and knowledgeable about the challenges and requirements of assisting uninsured individuals and communities disadvantaged by poverty, minority race/ethnicity, poor health status, language barriers, homelessness, and other factors. As states and communities nationwide gear up to provide outreach and enrollment assistance for the first time under the ACA, the experience of Massachusetts health centers offers valuable lessons to health centers nationally, and to other community-based efforts to reach and enroll millions of low-income uninsured Americans in health coverage

Community Health Centers in an Era of Health Reform: An Overview and Key Challenges to Health Center Growth

Today, over 1,100 federally funded community health centers play a vital role in ensuring access to health care for a predominantly low-income population in medically underserved communities. Health centers’ ability to provide comprehensive primary care and improve access to high-quality care while holding down health care cost growth has been well-documented. As health reform spurs coverage expansion and efforts to improve quality, the nation’s reliance on health centers is likely to grow. In the Affordable Care Act (ACA), Congress invested $11 billion over five years to expand the health center program, to broaden access to care in lower-income communities as coverage expands. As policymakers and others gear up for ACA implementation, understanding the role of health centers and the characteristics of the people they serve is increasingly important. This brief provides a current snapshot of health centers and discusses recent developments that can be expected to have a significant impact on health center growth in the coming years

Community Health Centers: A 2013 Profile and Prospects as ACA Implementation Proceeds

In 2013, more than 1,200 federally funded community health centers provided access to care for low-income populations living in medically underserved communities throughout the country. The Affordable Care Act made expansion of health centers a key part of its strategy for ensuring that these communities would realize the benefits of increased health insurance coverage for their residents. As health insurance coverage expands under the Affordable Care Act (ACA) and the demand for primary care increases, the role of health centers is likely to increase. A key question going forward is whether health centers’ expanded capacity, developed over the past five years, will be sustained going forward

Providing Outreach and Enrollment Assistance: Lessons Learned from Community Health Centers in Massachusetts

Six years ago, Massachusetts implemented a broad expansion of health coverage to the uninsured population in the state. Understanding that outreach and enrollment assistance would be essential to the success of the expansion, state policymakers provided for public education campaigns, but also for person-to-person, hands-on assistance, especially in communities with large numbers of uninsured people. Community health centers play a central role in this effort. As states and communities gear up to provide outreach and enrollment assistance under the ACA, the experience of the Massachusetts health centers offers lessons that can help inform current efforts to reach and enroll millions of low-income, uninsured Americans in health insurance. Recent interviews conducted with a sample of Massachusetts health centers point to four key findings: Finding #1: Intensive outreach and enrollment assistance is crucial to connect low-income, uninsured people with coverage. Finding #2: Assistance is not a one-time matter – it is needed at all stages of the enrollment process and to ensure continued coverage. Finding #3: Immediate access to enrollment assistance boosts the effectiveness of outreach efforts. Finding #4: Even when health reform is mature, the need for aggressive outreach and enrollment assistance remains high and the resource demands remain significant. The Massachusetts health center experience demonstrates that, in addition to broad public education about affordable insurance options and how to enroll, intensive one-on-one assistance is a vital complement to help disadvantaged populations and communities obtain and keep coverage that meets their needs. The intensive support they require, and ongoing rather than occasional needs for assistance, suggest the importance of sustained investment in outreach and enrollment efforts conducted by health centers and other organizations