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Management tools for Medicaid and State Children's Health Insurance Program (SCHIP)
W Pete Welch1, Barbara A Rudolph, Lynn A Blewett
1Center for Health Care Policy and Evaluation, CHCPE, UnitedHealth Group, Eden Prairie, Minn., USA. pete.welch@lewin.com
Abstract:
Medicaid and the State Children's Health Insurance Program need analytic tools to manage their programs. Drawing upon extensive discussions with experts in states, this article describes the state of the art in tool use, making several observations: (1) Several states have linked Medicaid/State Children's Health Insurance Program administrative data to other data (eg, birth and death records) to measure access to care. (2) Several states use managed care encounter data to set payment rates. (3) The analysis of pharmacy claims data appears widespread. The article also describes "lessons learned" regarding building capacity and improving data to support the implementation of management tools.
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