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Measurement of SCHIP Outcomes and Its Effects on Insurance Coverage

  • Effectiveness of Outreach. How did applicants find out about the program? What brought them into the enrollment site? Sources of outreach data may include:

    • Administrative data (Characteristics of new enrollees; patterns of enrollment by method—mail, on-site locations, etc.).
    • Site visits to places where SCHIP-eligible children and families are likely to be (Maternal and Child Health (MCH) clinics, hospital emergency rooms, etc.).
    • Media tracking information.

  • Effectiveness of Enrollment Strategies. What are the barriers facing applicants at the enrollment sites? Who enrolls at a center versus by mail? What are the characteristics of children who are enrolling in the program? Enrollment information can be gathered through:

    • Administrative data.
    • Enrollment-site visits.
    • Telephone surveys of applicants (i.e., exploring characteristics of those who do and do not enroll).

  • Effects on Stability of Coverage. Do those enrolled keep coverage? Why do they drop out? Do those who drop out obtain other coverage— (from where)? Sources of coverage stability information may include:

    • Administrative data: linking SCHIP and Medicaid files to track children moving back and forth between the two programs.
    • Follow-up survey of those who drop SCHIP coverage to assess reasons they have dropped.

  • Cost Per Newly Covered Child. System cost versus Federal cost. Have SCHIP dollars displaced some State and private non-profit funds? Sources of information include:

    • Administrative data.
    • Telephone surveys.

  • Displacement of Private Coverage. Would children enrolled in SCHIP otherwise have had other insurance coverage? Data sources include:

    • Administrative data.
    • Surveys of enrolled children.
    • Surveys of small employers and low-income workers.

  • Effects on Access. What difference has enrollment in SCHIP made for participants? (Refer to Lave JR, et al. June 1998. "Impact of a Children's Health Insurance Program on Newly Enrolled Children." globe.gif (1043 bytes) JAMA 279(22): 1820-5, for an example of this method.)

    • Administrative data from plans.
    • Participant surveys regarding physician visits and well-child care.

  • Effects on Appropriate and Inappropriate US of Services. (Refer to Lave JR, et al. June 1998. "Impact of a Children's Health Insurance Program on Newly Enrolled Children." globe.gif (1043 bytes) JAMA 279(22): 1820-5, for an example of this method.)

    • Administrative data from plans.
    • Surveys.
    • Comparison of National Immunization Survey (NIS) data before and after enrollment.

Related Questions

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What other methodological issues are discussed?

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