Health Center Patient Trends, Enrollment Activities, and Service Capacity: Recent Experience in Medicaid Expansion and Non-Expansion States

Issue Brief
  1. Health Resources and Services Administration. Negotiated Rulemaking Committee on the Designation of Medically Underserved Populations and Health Professional Shortage Areas: Final Report to the Secretary, Table 5. 2011. http://www.hrsa.gov/advisorycommittees/shortage/nrmcfinalreport.pdf

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  2. The total number of health centers in 2014 was 1,278 when health centers in the U.S. territories are included. Bureau of Primary Health Care, Health Resources and Services Administration. National 2014 Health Center Data, 2015. http://bphc.hrsa.gov/uds/datacenter.aspx?q=tall&year=2014&state=

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  3. Bureau of Primary Health Care, Health Resources and Services Administration. National 2014 Look-Alikes Data, 2015 http://bphc.hrsa.gov/uds/lookalikes.aspx?state=national

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  4. Shin P et al., A Profile of Community Health Center Patients: Implications for Policy, 2013, Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation and the RCHN Community Health Foundation. https://www.kff.org/medicaid/issue-brief/a-profile-of-community-health-center-patients-implications-for-policy/

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  5. Sharac J et al., How has the Affordable Care Act Benefitted Medically Underserved Communities? National Findings from the 2014 Community Health Centers Uniform Data System, 2015, Policy Research Brief No. 42, Geiger Gibson/RCHN Community Health Foundation Research Collaborative, George Washington University. http://www.rchnfoundation.org/?p=4998

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  6. Shin P et al., Assessing the Potential Impact of State Policies on Community Health Centers’ Outreach and Enrollment Activities, 2014, Policy Research Brief No. 35, Geiger Gibson/RCHN Community Health Foundation Research Collaborative, George Washington University. http://www.rchnfoundation.org/?p=3814

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  7. Data on health centers in the U.S. territories were excluded from this analysis.

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  8. The number of responses including health centers in U.S. territories was 693.

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  9. Kaiser Family Foundation. State Health Facts: Status of State Action on the Medicaid Expansion Decision, November 2015. https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/

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  10. Kaiser Family Foundation. Medicaid Eligibility for Adults as of January 1, 2014, https://www.kff.org/medicaid/fact-sheet/medicaid-eligibility-for-adults-as-of-january-1-2014/

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  11. Bureau of Primary Health Care, Health Resources and Services Administration. National 2014 Health Center Data, 2015. http://bphc.hrsa.gov/uds/datacenter.aspx?q=tall&year=2014&state=

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  12. Garfield R et al., The Coverage Gap: Uninsured Poor Adults in States That Do Not Expand Medicaid: An Update. Kaiser Family Foundation, 2015. http://files.kff.org/attachment/issue-brief-the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update

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  13. Shin P et al., Medicaid and Community Health Centers: The Relationship between Coverage for Adults and Primary Care Capacity in Medically Underserved Communities. Kaiser Family Foundation, 2012. https://www.kff.org/health-reform/issue-brief/medicaid-and-community-health-centers-the-relationship/

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  14. This hypothesis is consistent with recent findings that individuals with income of 100-150% FPL made up nearly half of Marketplace purchasers in non-expansion states, but under one-quarter of those in Medicaid expansion states.  U.S. Department of Health and Human Services. "Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report." ASPE Issue Brief (2015): 1-72. http://aspe.hhs.gov/pdf-report/health-insurance-marketplace-2015-open-enrollment-period-march-enrollment-report

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  15. Garfield et al., op. cit.

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  16. Artiga S et al., The impact of the coverage gap in states not expanding Medicaid by race and ethnicity, Kaiser Family Foundation, 2015. https://www.kff.org/disparities-policy/issue-brief/the-impact-of-the-coverage-gap-in-states-not-expanding-medicaid-by-race-and-ethnicity/

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  17. Schoen C et al., Health Care in the Two Americas: Findings from the Scorecard on State Health System Performance for Low-Income Populations, 2013, The Commonwealth Fund, 2013. http://www.commonwealthfund.org/publications/fund-reports/2013/sep/low-income-scorecard

     

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