Impact of SCHIP on Vulnerable Children: Findings from

1. Impact of SCHIP on Vulnerable Children: Findings from Cindy Brach, Agency for Healthcare Research and Quality

2. The Child Health Insurance Research Initiative (CHIRI™) • Public-private partnership: AHRQ, the Packard Foundation, and HRSA funded 9 studies of public child health insurance and delivery systems. • Policy Relevance: designed to supply policy makers with information to improve access to and the quality of health care for low-income children. • Emphasis on Vulnerable Children: children with special health care needs, minority children, adolescents. • Collaborative Process: strengthen individual studies and increase the generalizability.

3. AcademyHealth Meetings • Catalyst for joint analyses • Forum for sharing early findings and getting feedback • Networking opportunity with other researchers conducting studies on the topic

4. ARM 2001 Children with Special Health Care Needs Enrolled in SCHIP: Patient Characteristics and Health Care Needs. 2003. Peter G. Szilagyi, Elizabeth Shenkman, Cindy Brach, et al. Pediatrics 112( 6): e508-e520 • The prevalence of children with special health care needs (CSHCN) was higher among SCHIP enrollees than the general population. • CSHCN were similar to children without special health care needs, but CSHCN had poorer health status, were more likely to have had unmet needs, and were more likely to use the ED; mental health, specialty, and acute care in the year prior to enrolling in SCHIP.

5. ARM 2002 Who's Enrolled in SCHIP? Findings from the Child Health Insurance Research Initiative (CHIRI™) (2003). Cindy Brach, Eugene M. Lewit, Karen VanLandeghem, et al. Pediatrics 112( 6): e499-e507 • Most SCHIP enrollees lived in working families with incomes ≤ 150 % FPL; a significant proportion of enrollees were black or Hispanic, with racial and ethnic disparities present. • SCHIP enrollees have substantial and wide-ranging health care needs, despite high levels of prior contact with the health care system.

6. ARM 2002 Continued The Impact of SCHIP Enrollment on Physician Participation in Medicaid in Alabama and Georgia. 2004. Janet M. Bronstein, E. Kathleen Adams, Curtis S. Florence. Health Services Research 39(2): 299-315 • Increases in SCHIP enrollment had little effect on physician participation in Alabama's freestanding SCHIP program, which uses an open health care provider panel. • In Georgia, where the same provider network serves both Medicaid and SCHIP, increases in SCHIP enrollment were associated with a decline in office-based physician participation in Medicaid in urban areas.

7. ARM 2003 SCHIP Impact in Three States: How Do the Most Vulnerable Children Fare? In press. Andrew W. Dick, Cindy Brach, R. Andrew Allison, et al. Health Affairs. • SCHIP increased enrollees’ access to and satisfaction with health care • Vulnerable children – minority children, children and adolescents with special health care needs (CSHCN/ASHCN), and children who were uninsured for long periods of time – shared in these improvements. • Areas future improvement: unmet needs among CSHCN/ASHCN, and preventive care, especially for Hispanic children.

8. Copies of CHIRI™ Products and Other Findings Available from: • The CHIRI™ Web site: http://www.ahrq.gov/chiri/ • AHRQ Clearinghouse: 1-800-358-9295 • AHRQ Exhibit in Exhibit Hall

9. ARM 2004 Presentations • What Role Does SCHIP Play in the Patchwork Insurance System for Children? Andrew W. Dick • Improvement in Asthma Care After Enrollment in SCHIP Peter G. Szilagyi • The Impact of SCHIP Enrollment and Managed Care Organizational Characteristics on Preventive Care Elizabeth Shenkman