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Medicaid And Chip Trends
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Medicaid And Chip Trends

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A brief look at trends and patterns in Medicaid and CHIP enrollment in southeast Texas.

A brief look at trends and patterns in Medicaid and CHIP enrollment in southeast Texas.

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Medicaid And Chip Trends Medicaid And Chip Trends Presentation Transcript

  • A brief look at trends and patterns in Medicaid and CHIP enrollment and population at the ZIP code level in southeast Texas, 2005 to 2008 Patrick Courtney The University of Texas School of Public Health Health Services Research Collaborative
  • Background/Purpose
    • Trends can easily be illustrated when there is one unit of measurement (e.g. Harris County). However, examining separate trends for every area ZIP code at once is not feasible.
    • The following materials are meant to illustrate geographical trends that require further exploration. Researchers may wish to examine the causes of such patterns. Planners may wish to use this information to more effectively target their resources.
    • Varied types of data are presented in the maps (frequencies, rates, and percentages). Therefore, each type of data is divided differently for the purposes of mapping.
    • Area chosen: ZIP codes that comprise the Houston-Baytown-Sugarland metropolitan statistical area.
  • Data
    • Medicaid and CHIP enrollment: Texas Health and Human Services Commission, Center for Strategic Decision Support.
    • Population: ESRI, Inc. (manufacturer of ArcGIS, also a source of select population estimates to users of its software).
    • Population estimates supplied by ESRI are for total population. No further breakdown is possible.
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  • Comments
    • Some areas inside the 610 loop in Houston that show a high frequency of total Medicaid enrollment and total population also show a decline in total Medicaid enrollment and total population (e.g. Fifth and Third Ward areas, traditional safety net areas).
    • Some areas of Fort Bend County that show a high frequency of total Medicaid enrollment and total population show an increase in total Medicaid enrollment and total population (e.g. Richmond and Rosenberg).
    • While there is 2009 ZIP code level data on Medicaid enrollment, there is no 2009 ZIP code level data on total population.
    • There has been little change in population rates. Despite the decline in both Medicaid enrollment and population, large parts of Harris County maintain a high rate of Medicaid enrollment.
    • Many areas on the edges of the MSA have a high rate of Medicaid enrollment.
    • Exploration of data on select Medicaid eligibles is next.
  • Children and Aged/Blind/Disabled
    • Nationwide, families with children make up the majority of Medicaid enrollees, yet the aged, blind, and disabled make up the majority of Medicaid expenditures.
    • Other groups (e.g. TANF adults) are not represented here.
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  • Comments
    • While children still make up more than half of all Medicaid enrollees at the ZIP code level, their enrollment decline seems to parallel the decline in both enrollment and population for some areas (e.g. Fifth and Third Ward areas).
    • Medicaid enrollment in some of the traditional safety net areas of Harris County (e.g. Fifth and Third Wards, South Park, Sharpstown) appears to be shifting towards the aged, blind, and disabled populations.
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  • Comments
    • CHIP enrollment is on the rise in many areas of the MSA.
    • At the level of Harris County, the MSA, and the state of Texas (data not presented here), CHIP enrollment declined from 2003 to about 2005/2006. The growth in CHIP enrollment seen in this map may be related to the restoration of CHIP in 2005/2006.
  • A tale of two ZIP codes
    • 77004 – Third Ward, inside the 610 loop, location of many safety net services.
    • 77084 – Intersection of Katy Freeway and highway 6, one of the largest ZIP code populations in Texas (estimated to be larger than 77036).
  • General Conclusions
    • The universal is not always reflected in the particular. What is true of Harris County as a whole is not necessarily reflected at the ZIP code level.
    • A high rate of total Medicaid enrollment is found in many areas of the MSA outside of Harris County.
    • To a certain extent, Medicaid enrollment decline follows population decline and a possibly aging population.
    • Efforts to address the needs of Medicaid and CHIP enrollees should address not only traditional safety net areas, but also areas of population growth and the rest of the MSA. Population growth in the north and west sections of Harris County is not always middle and upper class income growth.
  • Limitations
    • Only two years of data (2005 and 2007). An exploration of multiple years and/or other ZIP code level population factors may yield a different picture (e.g. per capita income).
    • While Medicaid and CHIP enrollees are by definition nearly always <200% FPL, some may have 1) moved elsewhere, 2) aged out of Medicaid for children, 3) earned too much for Medicaid, 4) shifted to CHIP or the Harris County “gold card.”