Maine Rural Health Research Center

Role of Public versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children

Abstract: 

Medicaid and the Children’s Health Insurance Program (CHIP) have played a critical role in ensuring access to health insurance coverage among children and have been particularly important sources of coverage for rural children. More than 35.5 million children were enrolled in Medicaid or CHIP in September 2016—accounting for just over half of total Medicaid and CHIP enrollment. Given the large proportion of rural children covered by public insurance, it is critically important to understand the role of that coverage in ensuring access to affordable healthcare for rural children. Using data from the 2011-2012 National Survey of Children’s Health, researchers at the Maine Rural Health Research Center examined rural-urban differences in children’s access to care, and their families’ perceived affordability of that care among those enrolled in Medicaid or CHIP and those covered by private insurance. Findings indicate that public coverage supported access to care for low-income rural children and low-income rural families reported fewer problems paying medical bills for their child’s care. CHIP is up for reauthorization in 2017 and decisions about the program’s future should consider the potential implications for affordability of healthcare services among rural children.

FMI:  Erika Ziller, PhD

Suggested Citation: Ziller EC, Lenardson JD, Burgess AR. The Role of Public Versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; May, 2017. PB-67.

Publication Type: 
Research and Policy Brief
Publish Date: 
May 22, 2017
URL: 
http://muskie.usm.maine.edu/Publications/rural/Public-vs-Private-Insurance-Low-Income-Rural-Children.pdf

Mental Health Status and Access to Health Care Services for Adults in Maine

Abstract: 

Maine people with poor mental health describe significant challenges with affordability and access to health care.  A new report released by the Maine Health Access Foundation (MeHAF) and the University of Southern Maine, Mental Health Status and Access to Health Care Service for Adults in Maine, describes how adults 18 and older in Maine who report depression and poor mental health have many barriers to getting health care. These results have important implications for planning in a time when major changes in health insurance coverage are expected.

Analyzing data from the ongoing federal/state public health survey, the Behavioral Risk Factor Surveillance System (BRFSS), Dr. Ziller found that adults in Maine experiencing 14 or more mental health bad days are less likely to have a regular health care provider and more likely to report delays in getting needed health care services (for reasons other than cost). Poorer mental health status was associated with higher rates of foregoing needed medical care because of costs; 25 percent those adults experiencing 14 or more mental health bad days reported they were unable to access needed care from a doctor due to cost compared to 7 percent of adults with no mental health bad days.

MeHAF support allows inclusion of additional questions about access to insurance and health care services in the state’s BRFSS, which surveys a random sample of Maine people throughout the year.  Results from the compiled 2012, 2013 and 2014 surveys are included in the report.

 

For more information on the study design and methodology, please contact Erika Ziller, PhD, (207) 780-4615.

Media contact: Barbara Leonard, President & CEO, (207) 620.8266 x102

Suggested Citation: Ziller EC, Leonard B. Mental Health Status and Access to Health Care Services for Adults in Maine. Augusta, ME: Maine Health Access Foundation and USM Muskie School; February, 2017.

The brief is also available for download on the Maine Health Access Foundation website.

Publication Type: 
Research and Policy Brief
Publish Date: 
February 2, 2017
Author: 
URL: 
http://www.mehaf.org/content/uploaded/images/reports-research/MeHAF_MH-Status-Access-Brief-Feb2017_FINAL.pdf

Health Information Exchange: A Strategy for Improving Acess for Rural Veterans in the Maine Flex Rural Veterans Health Access Program

Abstract: 

This paper written by research staff at the Maine Rural Health Research Center reports on the design and implementation of a first in the nation project to expand rural veterans’ access to healthcare by establishing a bi-directional connection between Maine’s statewide health information exchange (HIE) and Veterans Administration facilities and centers. The paper reviews key factors that have contributed to implementation challenges and successes and lessons relevant to efforts to create interoperable health IT systems across multiple, complex organizational settings.


Implementation Lessons: Despite significant challenges, the Maine Rural Veterans Health Access Program (MeRVHAP) successfully established bi-directional connections with Maine’s statewide health information exchange (HIE), allowing for the exchange of clinical health information among U.S. Department of Veterans Affairs (VA) and non-VA providers.

Key factors that contributed to success include:
-A strong business case;
-Strong political and organizational commitment and leadership
-Project champions in the VA with enough seniority to overcome bureaucratic and technical hurdles
-Highly structured and detailed design and implementation plan
-Technical flexibility and capacity to adjust strategy mid-stream
-Collaboration and communication strategies developed by the stakeholders in the course of implementing this project which built a strong foundation for sustainability and replicability

 

For more information on this study, please contact Karen Pearson or Andrew Coburn

Suggested Citation: Pearson K, Burgess A, Gale J, Coburn A, Hansen A. Health Information Exchange: A Strategy for Improving Access for Rural Veterans in the Maine Flex Rural Veterans Health Access Program. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; May, 2016.

Publication Type: 
Working Paper
Publish Date: 
May 30, 2016
URL: 
http://muskie.usm.maine.edu/Publications/rural/Maine-Rural-Veterans-Health-Access-HIT-Strategies.pdf

The Role of Public versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children

Unpublished
Abstract: 

Medicaid and the Children’s Health Insurance Program (CHIP)have played a critical role in ensuring access to health insurance coverage among children and have been particularly important sources of coverage for rural children. More than 35.5 million children were enrolled in Medicaid or CHIP in September 2016—accounting for just over half of total Medicaid and CHIP enrollment. Given the large proportion of rural children covered by public insurance, it is critically important to understand the role of public health insurance in ensuring access to affordable health care for rural children. Using data from the 2011-2012 National Survey of Children’s Health, researchers from the Maine Rural Health Research Center examined rural-urban differences in children’s access to care, and their families’ perceived affordability of that care among those enrolled in Medicaid or CHIP and those covered by private insurance. Findings indicate that public coverage supported access to care for low-income rural children and low-income rural families reported fewer problems paying medical bills for their child’s care. CHIP reauthorization in 2017 is an important step in protecting low-income rural children’s access to affordable health care. In the event that CHIP funding ends, even those families that successfully transition to private health insurance are likely to face greater challenges in affording care for their children. Rural children who gain coverage through Qualified Health Plans in the Marketplace or who move into employer-sponsored insurance after losing public insurance will likely experience higher out-of-pocket costs compared with their experience in CHIP.

 

For more information on this study, please contact Erika Ziller, PhD

Suggested Citation: Ziller EC, Lenardson JD, Burgess AR. The Role of Public Versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; January, 2017. PB-67.

Publication Type: 
Research and Policy Brief
Publish Date: 
January 20, 2017
URL: 
http://muskie.usm.maine.edu/Publications/rural/Public-vs-Private-Insurance-Low-Income-Rural-Children.pdf

Maine Rural Health Research Center FAQ

Innovations in Rural Health System Development

Abstract: 

cover photo for Innovations in Rural Health System Development

In an effort to inform and promote local discussions and strategic planning for transforming health and healthcare in rural communities, the Maine Health Access Foundation commissioned the Maine Rural Health Research Center to develop five issue briefs profiling innovative approaches to rural health. The briefs present innovative approaches from Maine and other parts of the United States to the provision of behavioral health services, recruitment and retention of health care workers, service delivery, governance, and health care payment and financing in rural areas. Examples of innovative approaches profiled in the briefs include: the use of new health workers such as community paramedics and community health workers, rural-focused medical education models, alternative models of emergency care, telehealth, care coordination initiatives, Accountable Care Organizations, and Medicaid Accountable Communities.

The aim of these briefs is to assist rural communities and regions to proactively envision and develop strategies for transforming rural health in the state. In preparing these briefs the Maine Rural Health Research Center consulted experts, interviewed key informants, and reviewed the professional and research literature to find robust and innovative models and strategies that could be replicated in rural Maine.

Suggested citations:

Burgess A, Coburn A. Innovations in Rural Health System Development: Maine’s Behavioral Health Services. Portland, ME: University of Southern Maine, Muskie School of Public Service, MaineRural Health Research Center; November 2016.

Burgess A, Coburn A. Innovations in Rural Health System Development: Recruiting and Retaining Maine’s Health Care Workforce. Portland, ME: University of Southern Maine,Muskie School of Public Service, Maine Rural Health Research Center; November 2016.

Burgess A, Coburn A. Innovations in Rural Health System Development: Service Delivery Advances in Care Coordination, Emergency Care, and Telehealth. Portland, ME: University of SouthernMaine. Muskie School of Public Service, Maine Rural Health Research Center; November 2016.

Kahn-Troster S, Coburn A. Innovations in Rural Health System Development: Governance. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine RuralHealth Research Center; November 2016.

Kahn-Troster S, Coburn A. Innovations in Rural Health System Development: Moving Rural Health Systems to Value-Based Payment. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; November 2016.

Publication Type: 
Report
Publish Date: 
November 10, 2016
URL: 
http://www.mehaf.org/learning-resources/reports-research/

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