At the end of the study period, Congress will receive a comprehensive report on SCHIP, which addresses all the issues laid out in the legislation that mandated the evaluation. The report will encompass all research activities that take place under the study, as well as those conducted through a series of smaller, related ASPE-sponsored studies. The report will present findings of the four major analyses: (1) state context and SCHIP program design; (2) SCHIP enrollment and disenrollment; (3) links between SCHIP and Medicaid, uninsurance, and private coverage; and (4) SCHIP access, service use, and satisfaction. In addition, the report will address the major similarities and differences between the SCHIP and Medicaid populations.
The first analysis—on state context and program design—will examine the key contextual factors and design elements that define SCHIP programs and their program experience (enrollment, access, service use, and so on). The analysis draws on several qualitative sources, as displayed in Table B.1 by research question. The two most important sources are the case studies in the 10 study states and the survey of SCHIP administrators in all states and territories. In addition, several external studies—most notably, the focus group study—provide further insight into SCHIP program design and consumer experience.
The remaining three analyses explore the program experiences of SCHIP enrollees and disenrollees (see the lower panels of Table B.1). Each analysis relies on quantitative data, although the qualitative data provide important contextual information for interpreting results. The most important data source for these analyses is the survey of SCHIP enrollees and disenrollees across the 10 study states. Additional sources include the SLAITS survey of
TABLE B.1: SUMMARY OF QUESTIONS TO BE ADDRESSED IN THE FINAL REPORT TO CONGRESS
|Qualitative Data Sources||Quantitative Data Sources|
|Research Questions||Case Studies||Program Administrator Survey||External Studies||Survey of SCHIP Enrollees||Survey of SCHIP Disenrollees||State Eligibility/ Enrollment Data||SLAITS|
|State Context and Program Design|
|What are the key state characteristics influencing the development, implementation, or efficacy of SCHIP; and what are the specific design features of each state’s program?||Main||Main||ü|
|Why did states design SCHIP programs as they did? What factors drove the adoption of various policies and models among states, given the flexibility afforded by Title XXI?||Main||Main||ü|
|What are the perceived linkages (from state officials, program participants, policymakers, and other stakeholders) between individual mediating factors and various programmatic goals and outcomes?||Main||Main||ü|
|Enrollment and Disenrollment|
|Why do some eligible families enroll in SCHIP, while others do not; and what policies are effective in reducing the share who are eligible- but-uninsured?||ü||ü||Main||ü||ü||Main|
|Why do some eligible-enrolled families disenroll from SCHIP, while others do not; and what policies are effective in reducing the share of eligible enrollees who disenroll and become uninsured?||ü||ü||Main||Main||ü|
|What are the reasons for SCHIP disenrollment, and how likely are families to reenroll?||ü||ü||Main||ü|
|Links Between SCHIP, Uninsurance, Medicaid, and Private Coverage|
|What type of insurance coverage do SCHIP enrollees have prior to entering SCHIP and after leaving SCHIP?||Main||Main||ü|
|To what extent does the SCHIP program draw from those who would otherwise be uninsured or substitute for private or Medicaid coverage?||ü||ü||Main||ü|
|Access, Service Use, and Satisfaction|
|What kind of access to care, service use, and satisfaction with care do SCHIP enrollees experience under SCHIP?||ü||ü||Main||ü|
|To what extent does SCHIP lead to improvements in access to care, service use, and satisfaction with care for children who enroll?||ü||ü||Main||ü|
|Main = the primary source used for analyzing this question.
ü = a supplementary source used for analyzing this question.
low-income uninsured children, and the SCHIP program and enrollment files in each of the 10 study states.
A parallel analysis of the Medicaid program (not shown in Table B.1) will focus on these same three policy areas—namely, Medicaid enrollment and disenrollment, interactions between Medicaid and other types of coverage (and noncoverage), and the access to care, service use, and satisfaction of Medicaid recipients. This analysis will rely almost entirely on the survey Medicaid enrollees and disenrollees in 2 of the 10 study states, described previously.
By the time Congress receives the final report, the findings from these analyses will already have been presented in interim evaluation reports. The final report to Congress will synthesize findings from these reports in a concise, comprehensive review of key findings and conclusions.