Mapping the Delivery System Serving Low-Income Populations

This study will characterize the evolution of health systems serving low-income populations since the ACA’s enactment in 2010. Project staff will construct a comprehensive national database integrating up to 19 data sets that contain provider and hospital data; Medicare, Medicaid and commercial claims data; and demographic information. The new database will help answer key questions related to the adequacy of delivery systems serving low-income populations from region to region.

First, the project will analyze the availability of providers for low-income patients within “primary care service areas” — local geographic zones where individuals typically seek out primary care — and compare provider supply and organization in low- and high-income areas, as well as in Medicaid expansion states and nonexpansion states. For the second part of the study, project staff will analyze delivery system changes over time for low-income populations since the ACA’s passage. Intended for an audience of national policymakers, local delivery system leaders, and state Medicaid directors, the project’s findings could potentially inform the development of policies to ensure adequate access to high-quality, efficient care for vulnerable populations.