Program Churning and Transfers Between Medicaid and CHIP
Program Churning and Transfers Between Medicaid and CHIP
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DOI：
10.1016/j.acap.2015.02.006
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发表时间：
2015-05-01
影响因子：
3.1
通讯作者：
Harrington, Mary
中科院分区：
文献类型：
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作者：
Orzol, Sean M.;Hula, Lauren;Harrington, Mary
目的：在10个州是2009年儿童健康保险计划再授权法案评估的重点，我们详细分析了各州在保留儿童公共保险和公共保险搅动方面的最新进展。我们使用了从10个研究州收集的为期五年半的管理数据-阿拉巴马州，加州，佛罗里达，路易斯安那州，密歇根州，纽约，俄亥俄州，得克萨斯州，犹他州，和弗吉尼亚州，以分析在何种程度上儿童返回到同一程序后，短时间内取消和医疗补助和儿童之间的转移的程度。健康保险计划（CHIP）导致公共覆盖gaps.RESULTS：我们的分析产生了3个关键的发现。首先，许多儿童在医疗补助和CHIP之间转移;虽然大多数无缝过渡，但根据过渡类型，覆盖率差距高达40%。其次，流失仍然是公共保险计划的一个问题，大约21%的医疗补助计划退出者和10%的单独CHIP退出者在7个月内返回同一计划。第三，我们发现了相当大的差异，在10个研究state.Conclusions的程序搅动和非无缝程序传输率存在显着的变化，在整个程序和国家，这持续在公共程序搅动期间。这些结果表明，需要继续努力，以简化更新过程，特别是在国家医疗补助计划，沿着通过的过程，改善协调的计划和政策，简化这些转移。
OBJECTIVE: In the 10 states that are the focus of the Children's Health Insurance Program Reauthorization Act of 2009 evaluation, we analyze in detail the states' recent progress in retaining children in public coverage and public coverage churning.METHODS: We used administrative data spanning a five-and-a-half-year period collected from 10 study states-Alabama, California, Florida, Louisiana, Michigan, New York, Ohio, Texas, Utah, and Virginia-to analyze the extent to which children return to the same program a short time after disenrollment and the extent to which transfers between Medicaid and Children'.s Health Insurance Program (CHIP) lead to public coverage gaps.RESULTS: Our analysis yielded 3 key findings. First, many children moved between Medicaid and CHIP; while most transitioned seamlessly, coverage gaps occurred for as many as 40%, depending on the type of transition. Second, churning continued to be a concern 'for public coverage programs, with approximately 21% of Medicaid disenrollees and 10% of separate CHIP disenrollees returning to the same program within 7 months. Third, we found sizable differences in rates of program churning and nonseamless program transfers across the 10 study states.CONCLUSIONS: Notable variation existed across programs and states, which persisted over the period in public program churning. These results suggest the need for continued efforts to simplify renewal processes, particularly in state Medicaid programs, along with the adoption of processes that improve coordination across programs and policies that simplify these transfers.