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The Children's Health Insurance Program: expanding the framework to evaluate state goals and performance.

L Shi1, T R Oliver, V Huang

  • 1Johns Hopkins University, USA. lshi@jhsph.edu

The Milbank Quarterly
|October 12, 2000
PubMed
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A new framework evaluates the State Children's Health Insurance Program (SCHIP), finding state plans prioritize enrollment and access over service quality. A broader approach is needed for comprehensive SCHIP performance assessment.

Area of Science:

  • Health Services Research
  • Public Health Policy
  • Program Evaluation

Background:

  • The State Children's Health Insurance Program (SCHIP) was established in 1997 to provide health coverage to uninsured children.
  • Evaluating SCHIP's effectiveness requires a robust framework to assess state-level objectives and performance measures.
  • Existing evaluations may not fully capture the nuances of state program designs and outcomes.

Purpose of the Study:

  • To develop and apply a comprehensive framework for evaluating the State Children's Health Insurance Program (SCHIP).
  • To analyze the strategic objectives and proposed performance measures within state SCHIP applications.
  • To identify gaps in current SCHIP evaluation approaches, particularly concerning service quality.

Main Methods:

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  • Devised a comprehensive evaluation framework for SCHIP.
  • Analyzed program information from state SCHIP applications, focusing on objectives and performance measures.
  • Compared and contrasted objectives and measures across different states.

    • Main Results:

    • States propose a wide array of objectives and performance measures for SCHIP, with significant inter-state variation.
    • SCHIP plans predominantly emphasize program enrollment and access to services.
    • There is a notable lack of emphasis on the type and quality of services children receive post-enrollment.

    Conclusions:

    • A broader conceptual framework is necessary for a complete assessment of state goals and SCHIP performance.
    • Policymakers, advocates, and researchers need enhanced tools to evaluate SCHIP outcomes comprehensively.
    • Future evaluations should incorporate measures of service type and quality to provide a more holistic view of SCHIP effectiveness.