National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (3)
- (-) Children's Health Insurance Program (CHIP) (14)
- Children/Adolescents (11)
- Electronic Health Records (EHRs) (2)
- Healthcare Costs (1)
- Healthcare Utilization (2)
- Health Insurance (7)
- Low-Income (3)
- Medicaid (8)
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- Policy (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedHudson JL, Moriya AS
AHRQ Author: Hudson JL
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
This study examined the role of marketplace policy on “welcome mat” effects for children eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Data from the American Community Survey from 2013-2018 was used to estimate the relationship between Marketplace policy and increases in Medicaid/CHIP coverage among pre-ACA eligible children after the implementation of the Affordable Care Act (ACA). The sample included non-disabled citizen children ages 0-18 at 139-250% federal poverty level who were Medicaid/CHIP-eligible before and after implementation of the ACA. Marketplace policies and enrollment were compared in expansion states versus non-expansion states. Public coverage did increase more in states that empowered their Marketplace to enroll publicly-eligible applicants directly into Medicaid/CHIP. This was driven by enrollment policy, not by choice of state-based versus federal-based Marketplaces. Welcome mats were largest in expansion states and increases ranged from 9 to 13 percentage points in enrollment.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
Inquiry 2020 Jan-Dec;57:46958020952920. doi: 10.1177/0046958020952920..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Health Insurance, Policy, Uninsured, Access to Care
Soylu TG, Goldberg DG, Cuellar AE
Medicare access and CHIP reauthorization act in small to medium-sized primary care practices.
Despite major efforts to transition to a new physician payment system under the Medicare Access and CHIP Reauthorization Act (MACRA), little is known about how well practices are prepared. This study aimed to understand how small and medium-sized primary care practices in the Heart of Virginia Healthcare (https://www.vahealthinnovation.org/hvh/) perceived their quality incentives under MACRA.
AHRQ-funded; HS023913.
Citation: Soylu TG, Goldberg DG, Cuellar AE .
Medicare access and CHIP reauthorization act in small to medium-sized primary care practices.
J Am Board Fam Med 2020 Nov-Dec;33(6):942-52. doi: 10.3122/jabfm.2020.06.200142..
Keywords: Children's Health Insurance Program (CHIP), Medicare, Primary Care, Health Insurance
Apathy NC, Everson J
High rates of partial participation in the first year of the merit-based incentive payment system.
This article discusses concerns over the implementation of the Merit-based Incentive Payment System (MIPS) for clinicians, which was authorized with the Medicare Access and CHIP Reauthorization Act of 2015. Data was analyzed from 2017, the first implementation year of MIPS. The authors found that although 90% of participating clinicians reported performance equal to or better than the lower performance threshold of 3 out of 100, almost half of clinicians did not participate in at least one of the three program categories. Even with the low participation rate, 74% of clinicians who only partially participated in the program received positive payment adjustments. The findings underline concerns that the design may have been too flexible to effectively incentivize clinicians to make incremental progress across all targeted aspects of the program (quality, advancing care information, and improvement activities).
AHRQ-funded; K12 HS026395.
Citation: Apathy NC, Everson J .
High rates of partial participation in the first year of the merit-based incentive payment system.
Health Aff 2020 Sep;39(9):1513-21. doi: 10.1377/hlthaff.2019.01648..
Keywords: Payment, Medicare, Medicaid, Children's Health Insurance Program (CHIP), Health Insurance
Shah AY, LLanos K, Dougherty D
AHRQ Author: Dougherty D
State challenges to child health quality measure reporting and recommendations for improvement.
The authors sought to assess reporting barriers of the Children's Health Insurance Program (CHIP) and to identify potential opportunities for improvement. They found that low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming. They concluded that possible solutions to improve reporting would include funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction.
AHRQ-authored.
Citation: Shah AY, LLanos K, Dougherty D .
State challenges to child health quality measure reporting and recommendations for improvement.
Healthc 2016 Sep;4(3):217-24. doi: 10.1016/j.hjdsi.2016.03.001.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Medicaid, Quality Indicators (QIs)
Bailey SR, Marino M, Hoopes M
Healthcare utilization after a children's health insurance program expansion in Oregon.
This study used electornic health record data from 154 Oregon community health centers to evaluate children's healthcare utilization after the Children's Health Insurance Program (CHIP) expansion. The authors found that utilization among the newly-insured remained higher than the uninsured group. This finding confirms that Children's Health Insurance Program expansions are associated with increased utilization of essential pediatric primary and preventive care.
AHRQ-funded; HS021522; HS018569.
Citation: Bailey SR, Marino M, Hoopes M .
Healthcare utilization after a children's health insurance program expansion in Oregon.
Matern Child Health J 2016 May;20(5):946-54. doi: 10.1007/s10995-016-1971-7.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Healthcare Utilization, Children/Adolescents, Access to Care
Wherry LR, Kenney GM, Sommers BD
The role of public health insurance in reducing child poverty.
The researchers reviewed a growing body of evidence that public health insurance provides important financial benefits to low-income families and also reviewed the potential poverty-reducing effects of public health insurance coverage. They found that Medicaid plays a significant role in decreasing poverty for many children and families. They also reviewed emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. They concluded that the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children.
AHRQ-funded; HS021291.
Citation: Wherry LR, Kenney GM, Sommers BD .
The role of public health insurance in reducing child poverty.
Acad Pediatr 2016 Apr;16(3 Suppl):S98-s104. doi: 10.1016/j.acap.2015.12.011.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Low-Income, Medicaid
Kreider AR, French B, Aysola J
Quality of health insurance coverage and access to care for children in low-income families.
This study compared health care access, quality, and cost outcomes by insurance type (Medicaid, CHIP, private, and uninsured) for children in households with low to moderate incomes. It found that children with all insurance types experienced challenges in access to specialty care, with caregivers of children insured by the Children’s Health Insurance Program reporting the highest rates of difficulty accessing specialty care, problems obtaining a referral, and frustration obtaining health care services.
AHRQ-funded; HS021706.
Citation: Kreider AR, French B, Aysola J .
Quality of health insurance coverage and access to care for children in low-income families.
JAMA Pediatr 2016 Jan;170(1):43-51. doi: 10.1001/jamapediatrics.2015.3028..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Access to Care, Low-Income
Christensen AL, Zickafoose JS, Natzke B
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
This study assessed the relationship between having a patient-centered medical home and use of health services by children enrolled in Medicaid in three States. The researchers found that medical homeness was not associated with the likelihood of receiving well-child care. Association of medical homeness with non-urgent, preventable, or avoidable emergency department visits varied.
AHRQ-funded; 290200900019I
Citation: Christensen AL, Zickafoose JS, Natzke B .
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
Acad Pediatr. 2015 May-Jun;15(3):267-74. doi: 10.1016/j.acap.2014.12.001..
Keywords: Children/Adolescents, Medicaid, Patient-Centered Healthcare, Children's Health Insurance Program (CHIP), Healthcare Utilization
Hudson JL, Hill SC, Selden TM
AHRQ Author: Hudson JL, Hill SC, Selden TM
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
This study investigated the potential health insurance options available to low-income children if federal CHIP funding ends in 2017 or if federal requirements change in 2019, allowing states to roll back Medicaid- and CHIP-eligibility thresholds to minimum levels. It found that the percentage of low-income children ineligible for public coverage or subsidized Marketplace coverage would increase from 22 percent in 2014 (12.5 million children) to 46 percent after 2019 (26.5 million children).
Citation: Hudson JL, Hill SC, Selden TM .
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
Health Aff 2015 May;34(5):864-70. doi: 10.1377/hlthaff.2015.0004..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Health Insurance, Low-Income
Pati S, Wong AT, Calixte RE
Medicaid and CHIP retention among children in 12 states.
The authors sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level. They found that all 3 metrics demonstrated reproducible estimates at the state level. Reproducibility of relative rankings for child health insurance retention of counties within states were sensitive to county child population size and the amount of variability in retention rates within the county and at the state level.
AHRQ-funded; HS020508.
Citation: Pati S, Wong AT, Calixte RE .
Medicaid and CHIP retention among children in 12 states.
Acad Pediatr 2015 May-Jun;15(3):249-57. doi: 10.1016/j.acap.2014.09.012.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
Selden TM, Dubay L, Miller GE
AHRQ Author: Selden TM, Miller GE
Many families may face sharply higher costs if public health insurance for their children is rolled back.
If possible cuts to the Children’s Health Insurance Program (CHIP) and elimination of the Affordable Care Act’s “maintenance of effort” provisions regarding Medicaid and CHIP take place; this study shows that many families would face sharply higher costs of providing insurance coverage for their children.
AHRQ Author
Citation: Selden TM, Dubay L, Miller GE .
Many families may face sharply higher costs if public health insurance for their children is rolled back.
Health Aff. 2015 Apr;34(4):697-706. doi: 10.1377/hlthaff.2015.0003..
Keywords: Children's Health Insurance Program (CHIP), Healthcare Costs, Children/Adolescents
DeVoe JE, Tillotson CJ, Angier H
Predictors of children's health insurance coverage discontinuity in 1998 versus 2009: parental coverage continuity plays a major role.
This study examines the strength of association between known and potential predictors of children’s health insurance continuity in both 1998 and 2009. It found that, compared to children with at least one parent continuously covered, children whose parents did not have continuous coverage had a significantly higher relative risk of a coverage gap.
AHRQ-funded; HS018569.
Citation: DeVoe JE, Tillotson CJ, Angier H .
Predictors of children's health insurance coverage discontinuity in 1998 versus 2009: parental coverage continuity plays a major role.
Matern Child Health J 2015 Apr;19(4):889-96. doi: 10.1007/s10995-014-1590-0.
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Keywords: Medical Expenditure Panel Survey (MEPS), Children's Health Insurance Program (CHIP), Uninsured, Health Insurance
DeVoe JE, Marino M, Angier H
Effect of expanding Medicaid for parents on children's health insurance coverage: lessons from the Oregon Experiment.
This study estimated the effect on a child’s health insurance coverage status when (1) a parent randomly gains access to health insurance and (2) a parent obtains coverage. It found that children’s odds of having Medicaid or CHIP coverage increased when their parents were randomly selected to apply for Medicaid. Children whose parents were selected and subsequently obtained coverage benefited most.
AHRQ-funded; HS018569
Citation: DeVoe JE, Marino M, Angier H .
Effect of expanding Medicaid for parents on children's health insurance coverage: lessons from the Oregon Experiment.
JAMA Surg. 2015 Mar;150(3):223-8. doi: 10.1001/jamasurg.2014.2239..
Keywords: Medicaid, Health Insurance, Children's Health Insurance Program (CHIP), Children/Adolescents
Miller D, Noonan K, Fiks AG
Increasing pediatrician participation in EHR incentive programs.
The authors addressed potential causes of the variability of pediatrician registration in the meaningful use (MU) program and suggested specific solutions to support effective pediatric electronic health record implementation across all states. They concluded that implementing their proposed solutions would support pediatricians’ use of electronic health records, with an ultimate goal of improving child health.
AHRQ-funded; HS022689.
Citation: Miller D, Noonan K, Fiks AG .
Increasing pediatrician participation in EHR incentive programs.
Pediatrics 2015 Jan;135(1):e1-4. doi: 10.1542/peds.2014-2438.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Provider: Health Personnel, Medicaid, Children/Adolescents