N. Halfon et al., Enrollment in the state child health insurance program: A conceptual framework for evaluation and continuous quality improvement, MILBANK Q, 77(2), 1999, pp. 181
Children's enrollment in the State Child Health Insurance Program (SCHIP) i
s a key indicator of program impact. Past studies demonstrate that many chi
ldren eligible for Medicaid or for private employer-based insurance remain
uninsured, indicating that eligibility does not guarantee either enrollment
or access to medical care. Important features of SCHIP evaluation include
not only eligibility thresholds and enrollment volume, but also program ret
ention, transitions in coverage, and access to medical care. Focusing on SC
HIP features that affect children's participation and continuity of coverag
e would allow states to continually improve procedures that affect enrollme
nt. An exploration of federal and state policy options suggests several app
roaches for creating evaluation strategies that can stimulate ongoing impro
vement.