BilheimerView Graph # 1 KEY POLICY QUESTIONS FOR THE STATES What Is the Problem of Uninsured Kids in the State? What Are We Doing to Address That Problem?

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Presentation transcript:

BilheimerView Graph # 1 KEY POLICY QUESTIONS FOR THE STATES What Is the Problem of Uninsured Kids in the State? What Are We Doing to Address That Problem? How Effective Are the Interventions and How Might We Improve Programs in the Future?

BilheimerView Graph # 2 KEY EVALUATION ISSUES FOR THE STATES Defining the Target Population State Versus National Evaluation Federal Reporting Requirements Data and Methods - Sample surveys - Administrative databases - Qualitative analyses based on site visits

BilheimerView Graph # 3 DEFINING THE PROBLEM What Proportion of Low-Income Kids Are Uninsured Now? What Is the 5-Year Baseline for Uninsured Low- Income Kids? How Does Lack of Coverage Affect: - Access to health services? - Use of health services? - Other aspects of well-being?

BilheimerView Graph # 4 ESTIMATING THE PROPORTION OF LOW-INCOME KIDS WHO ARE UNINSURED Need Estimates Now Sample Surveys Are Essential National Sample Surveys Are of Limited Use Use Telephone Surveys? - SLAITS - BRFFS Are Standardized Measures Available?

BilheimerView Graph # 5 DEVELOPING A HEALTH INSURANCE BASELINE Projection of Coverage Trends in the Absence of S- CHIP Effects of Welfare Reform Trends in Employer-Sponsored Coverage Changes in State and Private Initiatives

BilheimerView Graph # 6 DETERMINING EFFECTS OF LACK OF INSURANCE ON ACCESS, USE, AND WELL-BEING State-Specific Baseline Estimates vs. National Research Have a Limited Number of Access and Use Questions on Telephone Survey?

BilheimerView Graph # 7 DEFINING THE INTERVENTION What Are the Goals for the Program? What Are the Initiatives for Achieving Each Goal? What Resources Will Be Allocated to Each Initiative? What Measures Will Be Used for Monitoring and Evaluation?

BilheimerView Graph # 8 EFFECTS ON INSURANCE COVERAGE (1) Effectiveness of Outreach - Administrative data - Site visits - Media tracking information Effectiveness of Enrollment Strategies - Administrative data - Site visits - Telephone surveys

BilheimerView Graph # 9 EFFECTS ON INSURANCE COVERAGE (2) Effects on Stability of Coverage - Administrative data: linking S-CHIP and Medicaid files - Follow-up survey of dropouts Cost Per Newly Covered Child: System Cost Vs. Federal Cost - Administrative data - Telephone surveys

BilheimerView Graph # 10 EFFECTS ON INSURANCE COVERAGE (3) Displacement of Private Coverage - Administrative data - Surveys of enrolled kids - Surveys of small employers and low-income workers

BilheimerView Graph # 11 EFFECTS ON ACCESS, USE, AND WELL-BEING Issue for State or National Evaluation? Effects on Access - Administrative data from plans - Surveys Effects on Appropriate and Inappropriate Use - Administrative data from plans - Surveys - NIS

BilheimerView Graph # 12 EFFECTS OF STATE STRATEGIES Rely on National Evaluation?