CRIHB Research Documents for National American Indians and Alaska Natives
Analysis of Medicaid Payments for American Indians and Alaska Natives
The Indian Health Service (IHS) is a federal program that provides only part of the health care needed by the American Indians and Alaska Natives (AIAN) who use the IHS and Tribal health care facilities of the IHS system. The facilities serve remote rural areas, often as the only local provider and often with higher per capita costs than providers serving less remote, larger populations. When specialized outpatient or hospital care is needed, the care must be paid through contracts with providers (Contract Health Services) if funds allow, or AIAN must find another way to pay non-IHS providers for the care they need. Because the IHS is funded through the discretionary part of the federal budget, the IHS estimates that it provides only about 54% of the per capita costs of health care needed by AIAN they serve. In 1976 Congress authorized providers of the IHS system to bill Medicaid and Medicare programs for users of their facilities who are eligible for the programs. Children’s Health Insurance Program (CHIP) payments to the IHS and Tribal providers were authorized when program benefits first became available in 1997.
Medicare Statistics For American Indians & Alaska Natives
Medicare databases present special challenges in identifying and reporting on the two different groups of AIAN highlighted in provisions of the Affordable Care Act. This report investigates how well Medicare data might provide information on health care received by AIAN in both groups. We use Medicare enrollment and utilization data together with Census survey data on health care coverage to assess three things: 1) How well Medicare data identifies AIAN using the IHS health care system (IHS AIAN), 2) How well Medicare data identifies racial AIAN (Self-declared AIAN), and 3) The extent to which Medicare pays for IHS AIAN Active User health care costs can be estimated with Medicare data.
Health Care Coverage & Income of American Indians & Alaska Natives: A Comparative Analysis of 33 states with Indian Health Service Funded Programs
As the nation prepares for the implementation of health exchange programs created pursuant to the Patient Protection and Affordable Care Act (ACA) passed in 2010, many health planners are working to identify what impact these new programs and rules will have on their communities. American Indian and Alaska Native (AIAN) tribes face these issues with particular interest, since a large percentage of AIAN tribal people will be eligible for the new programs. AIANs suffer the highest disparity rates in many socioeconomic and health status measures. They are also amongst the highest uninsured populations in the United States. However, a singular description of AIANs is inadequate to effectively help tribal and state leaders design their programs and to set priorities. Just as the culture and tradition variances between Indian peoples are great, so are individual AIAN community experiences with regard to health care coverage, access to Indian Health Service (IHS) health care and income distribution.
Uninsured American Indians and Alaska Natives with Incomes 133% to 300% of Poverty: Data for Health Insurance Exchange Outreach
As outreach efforts increase to offer affordable health insurance to low income American Indians and Alaska Natives (AIAN), there is a need to know how many uninsured AIAN there in the administrative Areas of the Indian Health Service health care system to tailor the efforts to the different needs of AIAN in and out of that system. This report shows how the data from the American Community Survey of the U.S. Census Bureau can be used to provide this information.
Gaps and Strategies to improve American Indian and Alaska Native Data for Medicare, Medicaid and CHIP
American Indian and Alaska Native MEDICARE PROGRAM AND POLICY DATA Summary Report
AIAN Medicare Statistics 2009 (pdf format)
State Medicaid programs gather data on American Indians and Alaska Natives (AIAN) and healthcare providers of the Indian Health Service health care system. This report assesses how completely and accurately they are able to achieve that goal, and what could be done to improve their success.
AIAN Medicaid Data Collection Report 2010 (pdf Format)
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