SCHIP Evaluation. Evaluation Overview


In the Balanced Budget Refinement Act of 1999, Congress mandated that the Department of Health and Human Services (DHHS) conduct an evaluation of the State Children’s Health Insurance Program (SCHIP) to determine the effectiveness of the program and to provide information to guide future federal and state policy. The Department’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) has contracted with Mathematica Policy Research, Inc. (MPR) and its subcontractors, the Urban Institute and MayaTech Corporation, to carry out the major components of this three-year SCHIP evaluation.

As Congress mandated, ASPE’s evaluation will examine the experience of ten states selected to produce a mix of program designs, geographic regions, and demographic variables, and to capture a high proportion of the nation’s low-income children who were uninsured at the time SCHIP was established. The ten states are: California, Colorado, Florida, Illinois, Louisiana, Missouri, New Jersey, New York, North Carolina, and Texas.

ASPE’s evaluation includes both quantitative and qualitative research components. The cornerstone of the quantitative component will be a cross-sectional survey of SCHIP and Medicaid enrollees and disenrollees in the ten study states. In addition, a survey of households with children who are eligible but uninsured will be conducted. Analysis of other national, population-based surveys will also be included. Together with state program and enrollment data, these efforts will produce rich descriptive information on the characteristics and experiences of the target population for SCHIP and Medicaid – enrollees, disenrollees, and those who are eligible but remain uninsured. The design will support comparisons across these three groups and sub-populations within them, and across states and groups of states. Rigorous examination of the linkages between key analytic elements, including demographic variables, program design features, and outcomes such as reported barriers, access, and satisfaction, will be a major contribution of the quantitative research.

The principal qualitative analytic component of the evaluation will be in-depth case studies in the ten states. The case studies will improve our understanding of states’ program design choices, their implementation processes and challenges, and the perceptions of a broad range of stakeholders – all providing a context for interpreting the quantitative findings. A survey of all SCHIP administrators will provide a broader national picture. Finally, a focus group study of families in the Medicaid and SCHIP target populations (being conducted under a separate contract) will provide insights into the experiences and program perceptions of the families of eligible children. This study’s illumination of important themes and patterns will enrich the interpretation of findings from the surveys, case studies, and other research efforts that are part of this evaluation.

ASPE plans a wide dissemination of the findings of the evaluation through a series of reports over the coming three years. The first report will be delivered to Congress in early 2003.

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