Assessing Key Issues Affecting
Service Delivery
To meet the health care needs of children, State officials will need to think beyond
the benefits package and also consider service delivery issues.
SCHIP Workshop presenters Chris DeGraw of George Washington University, Shelly Gehshan of the National Conference of State
Legislators, and Denise Holmes of the Michigan
Medical Services Administration offered their views on various aspects of service delivery systems that
will be important to consider in the development of SCHIP programs.
Key service delivery issues State officials will want to consider are:
Two States’ Experiences with Service Delivery Issues:
Shelly Gehshan of the National Conference of State Legislatures’ Forum for State
Health Policy Leadership, summarized the key issues in SCHIP service delivery:
- Significant differences will exist between States on what benefits
children can receive according to the type of program implemented and service system
chosen.
- New funding sources such as SCHIP create shifts in service delivery systems,
that produce winners and losers in the service delivery system.
- Historic problems with specific services and populations will need to be
specifically addressed in the development of SCHIP service delivery systems.
States’ experiences in addressing these issues during Medicaid expansions will be
helpful as they attempt to do so.
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Benefit Design 
