Performance Improvement 1999. State Children's Health Insurance Program

02/01/1999

TITLE: An Analysis of Implementation Issues Relating to CHIP Cost-Sharing Provisions for Certain Targeted Low-Income Children

ABSTRACT: Title XXI of the Social Security Act permits State Children's Health Insurance Programs (CHIP) to impose cost sharing on beneficiaries, when the program is not an expansion of the State's Medicaid program. Under Medicaid, cost-sharing for services to children is prohibited. This project analyzes cost-sharing models that can be used by States to track cumulative out-of-pocket expenditures for State CHIP activities and employer-based health insurance plans that participate in CHIP; and reviews findings from studies that examine the relationships among health insurance premiums, cost-sharing arrangements, and enrollment and utilization by low income families. Findings will inform guidance for States in designing cost-sharing provisions for the CHIP plans.

AGENCY SPONSOR: Office of the Administrator

FEDERAL CONTACT: Marcia K. Brand, Ph.D.

PHONE NUMBER: 301-443-4619

PIC ID: 7129

PERFORMER ORGANIZATION: The George Washington University, Washington, D.C.

PROJECTED DATE OF COMPLETION: 4/30/99
 

TITLE: The Impact of the State Children's Health Insurance Program on Selected Community Health Centers and Maternal and Child Health Programs

ABSTRACT: This study is assessing: (1) the effect of the State Children's Health Insurance Program (CHIP) on the insurance status of children served by selected Community Health Centers (CHCs) and Maternal and Child Health (MCH) programs, and (2) the impact on the extent to which these children enter or remain in care at selected CHC and MCH sites. Issues to be addressed include: (1) the insurance history of children who have used or are new to the site; (2) the continuous nature and time span of the coverage; (3) insurance characteristics of, and source of care for, children who are no longer users; and (4) the characteristics of sites relative to their ability to enroll and/or retain newly insured children. Previous analysis of CHC encounter files documented significant volatility in coverage, with patients going on and off coverage as many as five times in a given year. Study findings will provide a framework for future investigation, develop a transferable methodology for use by States and sites, and help to assess the extent to which CHIP has affected the insurance coverage of children served by CHCs and MCH programs.

AGENCY SPONSOR: Bureau of Primary Health Care

FEDERAL CONTACT: Vilma Cokkinides, Ph.D.

PHONE NUMBER: 301-594-3730

PIC ID: 7125

PERFORMER ORGANIZATION: The George Washington University, Washington, D.C.

PROJECTED DATE OF COMPLETION: 9/30/00