mmpc - National Indian Health Board

Findings
Percent of IHS Active Users who are Medicaid enrollees (column B). The Medicaid enrollment rate for IHS
Active Users was determined during the linkage of IHS Registry data to this Medicaid enrollee data (see
Methods and Table 2 in the 2011 report Integrating Medicaid and Indian Health Service Data).
Percent of IHS Active User Medicaid Enrollees who are Recipients of Medicaid Paid Services (column C).
The Medicaid participation rate of enrollees was determined by dividing the number of IHS AIAN Medicaid
enrollees that had paid claims of more than zero dollars in column A, by all the IHS AIAN Medicaid
enrollees (Attachment Table C.3).
When expressed as a percent of the FDI Adjusted Benchmark Costs, the Areas with lowest fractions of health
care costs paid by Medicaid for their IHS Active User population are Nashville (19%) and Oklahoma (21%)with
a Medicaid Fraction of about one-fifth ( Figure 15). Aberdeen, California, Albuquerque, Portland and Bemidji
Areas have mid-range fractions of between a little more than one quarter and a little less than one-third (27% to
31%). Alaska and Billings are in the middle of the Area rankings with a little more than one-third of the costs
paid by Medicaid (34% to 38%). And Navajo and Phoenix have Medicaid fractions of nearly one half (46% and
49% respectively). Tucson has the highest Medicaid paid fraction of nearly two-thirds (65%).
Figure 20. Medicaid Alternate Resources paid to all providers as percent of IHS calculated FDI benchmark health care costs
for IHS Active Users in each Area.
Nashville
Oklahoma
Aberdeen
California
Albuquerque
Portland
Bemidji
Billings
Alaska
Navajo
Phoenix
Tucson
19%
21%
27%
29%
29%
30%
31%
34%
38%
46%
49%
Medicaid Fraction Paid to IHS and Tribal Providers for IHS Active Users
Using the Medicaid IHS Program claims payment data for IHS AIAN Medicaid recipients we can calculate the
expected Mean Medicaid IHS Program Payment per IHS Active User to IHS and Tribal (I/T) providers. We
substitute the unadjusted Mean Medicaid IHS Program Payment per IHS AIAN Recipient for the Total Payment
in the calculations in Table 14 to obtain the percents in Figure 16.
When the outcomes are expressed as a percent of the FDI Adjusted Benchmark Cost, the Areas with I/T
providers with the lowest reported Alternate Resources for IHS Active User Medicaid enrollees are Nashville
(2%), Bemidji (4%), Oklahoma (4%) and California (6%), (Figure 15). For Portland, Albuquerque, and Aberdeen
Areas only 8% of all Medicaid payments are to IHS and Tribal providers for health care costs of their Active
Users, and Alaska Area is only 9%. Medicaid resources Billings (12%), Navajo (19%), Phoenix (21%), and
Tucson Areas (24%) have the highest relative Medicaid resources.
39
65%
0% 20% 40% 60% 80% 100%
Percent of FDI Benchmark Cost
All Providers