Findings from University of Illinois Broadens Understanding of Managed Care (Variation In Medicaid And Medicare Payment Rates To Community Health Centers, 2023): Managed Care

2026 APR 21 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A new study on Managed Care is now available. According to news reporting out of Ghent, Belgium, by NewsRx editors, research stated, “In recent years, community health centers (CHCs) have struggled to meet the needs of underserved communities because of limited resources and growing demand. Medicaid and Medicare use prospective payment systems (PPSs) to reimburse CHCs at enhanced rates to safeguard their financial stability by providing consistent and predictable payments.”

Our news journalists obtained a quote from the research from the University of Illinois, “However, whether and how these rates vary across centers is unknown. In this study, we conducted the first known analysis of Medicaid and Medicare PPS rates across CHCs by compiling a novel data set from forty-two states and Washington, D.C. We found that Medicaid PPS rates were 23 percent higher, on average, than Medicare PPS rates in 2023. Concerningly, centers that served more patients who identified as non-Hispanic Black, were uninsured, or had more chronic conditions received lower PPS rates. Overall, we observed that payment rates were generally insufficient to offset the average per visit cost of care delivered in CHCs.”

According to the news editors, the research concluded: “Standardized policies concerning how public insurance payers reimburse CHCs are needed to promote equity and sustainability in the health care safety net.”

This research has been peer-reviewed.

For more information on this research see: Variation In Medicaid And Medicare Payment Rates To Community Health Centers, 2023. Health Affairs, 2026;45(4):413-422.

Our news journalists report that additional information may be obtained by contacting Aline Vandenbroeck, Aline Vandenbroeck, University of Illinois and Ghent University, Ghent, Belgium. Additional authors for this research include Justin H. Markowski and Chima D. Ndumele.

(Our reports deliver fact-based news of research and discoveries from around the world.)