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John F Steiner - One of the best experts on this subject based on the ideXlab platform.
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changes in access utilization and quality of care after enrollment into a state Child Health Insurance plan
Pediatrics, 2005Co-Authors: Allison Kempe, Brenda L Beaty, Lori A Crane, Johan Stokstad, Jennifer Barrow, Shira Belman, John F SteinerAbstract:Background. There currently are few published data evaluating the effect of State Children9s Health Insurance Programs on Health care outcome measures in Children. Colorado9s Child Health Plan Plus (CHP+) is a non-Medicaid State Children9s Health Insurance Program that began enrollment in April 1998. The objectives of this study were to compare reported (1) access to care, (2) utilization of Health care, and (3) quality of care during the year before and the first year after enrollment into CHP+. Methods. We interviewed 480 randomly selected families by telephone 2 months after their first enrollment into CHP+ (September 1999 to January 2000) and, again, 1 year later. We used generalized linear models to examine the effect of enrollment on Health care access, utilization, and quality while controlling for type of previous Insurance, length of time uninsured before enrollment, race/ethnicity, and age. Results. Regarding access to care, the percentage of families who reported a usual site of preventive care did not change significantly, but families reported more often being able to see providers as soon as desired for routine care (incidence ratio [IR]: 2.03; 95% confidence interval [CI]: 1.37–3.02]), for care when sick or injured (IR: 2.77; 95% CI: 1.85–4.16), for specialty care (IR: 1.96; 95% CI: 1.16–3.32), and for all Health care (IR: 2.35; 95% CI: 1.81–3.07). Unmet medical needs decreased after versus before enrollment for prescription medications (IR: 0.38; 95% CI: 0.26–0.55), mental Health care (IR: 0.63; 95% CI: 0.40–0.97), prescription glasses (IR: 0.44; 95% CI: 0.29–0.65), and dental care (IR: 0.59; 95% CI: 0.47–0.76). Regarding utilization, the proportion who saw a provider for routine care in the past year increased (IR: 1.39; 95% CI: 1.06–1.83), but reported visits for sick, specialty, and emergency department care and hospitalizations did not increase. Regarding quality of care, the proportion who rated their Health care as “best” increased (RI: 1.31; 95% CI: 1.04–1.66) after versus before enrollment. Conclusions. Families who were newly enrolled into CHP+ perceived dramatic increases in access to all types of care and decreases in unmet medical needs, no increase in utilization of emergency department or hospitalization services, and improved overall quality of care in the year after enrollment into CHP+.
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disenrollment from a state Child Health Insurance plan are families jumping s c hip
Ambulatory Pediatrics, 2004Co-Authors: Allison Kempe, Brenda L Beaty, Lori A Crane, Johan Stokstad, Jennifer Barrow, Shira Belman, John F SteinerAbstract:Background.—Colorado's Child Health Plan Plus (CHP+) is a non-Medicaid state Child Health plan that began enrollment in April 1998. Families are disenrolled 12 months after enrollment if they fail to re-enroll. Objective.—To assess Insurance coverage before and 1 year after initial enrollment in CHP+; reasons for disenrollment; and factors associated with re-enrollment. Design/Methods.—We interviewed 480 randomly selected families 2 months after initial enrollment into CHP+ (September 1999 through January 2000) and 1 year later. Results.—Prior to CHP+, 38% of families had Medicaid (MK), 35% were privately insured (PI), 6% were uninsured (UI), and 20% had other/unknown Insurance. After the 12 months, 34% were re-enrolled, 16% got other Insurance (6% MK, 10% PI/other), 4% had Children older than 18 years, and 46% were UI (9% had intentionally and 37% had unintentionally disenrolled from CHP+). All unintentionally disenrolled families were planning to re-enroll and 90% still appeared eligible. In multivariate analysis, having a primary care provider prior to enrollment was associated with re-enrollment (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1 to 2.6), but having problems with the application process impeded re-enrollment (OR 0.7, 95% CI 0.6 to 0.9). Conclusions.—Only about a third of families eligible for State Children's Health Insurance Program successfully re-enrolled before their termination date. Institution of a passive renewal process would decrease unnecessary disenrollment in eligible families.
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the first 2 years of a state Child Health Insurance plan whom are we reaching
Pediatrics, 2003Co-Authors: Allison Kempe, Jennifer Barrow, Brenda L Renfrew, Darci Cherry, Arnold H Levinson, John F SteinerAbstract:Objective. The Colorado Child Health Plan Plus is a non-Medicaid state Child Health Insurance Plan. The objective of this study was to compare early enrolling (EE) Children with uninsured Children in low-income families (ULI) with respect to 1) sociodemographic factors and previous Insurance, 2) Health status, and 3) previous Health care access and utilization. Methods. Cross-sectional telephone surveys were conducted during 1999 of 1) randomly selected EE Children (n = 711) and 2) ULI Children identified by random-dial survey (n = 105). Results. Enrolling Children were less likely to be Hispanic (32.7% vs 55.2%); 5.5% of EE versus 27.6% of ULI Children had never been insured. Prevalence of chronic conditions was similar (16.2% of EE vs 13.5% of ULI Children), but learning/behavioral difficulties (9.7% of EE vs 18.6% of ULI) and fair/poor Health (5.4% of EE vs 17.2% of ULI) were higher for uninsured Children. In the previous year, 88.2% of EE versus 66.1% of ULI Children had a usual source of care. The mean number of preventive visits was similar (1.4 vs 1.2), but the EE group reported a higher mean number of sick visits (2.0 vs 1.1), emergency visits (0.48 vs 0.15), and hospitalizations (0.09 vs 0.02). Conclusions. In the first 2 years of the program, Child Health Plan Plus is not yet reaching the “hard-to-reach” but, rather, disproportionately high numbers of non-Hispanic Children who already have a usual source of care and recent Insurance. EE Children did not have higher rates of chronic conditions but did demonstrate higher utilization before enrollment, possibly reflecting patterns of enrollment into the program.
Michael F Lovenheim - One of the best experts on this subject based on the ideXlab platform.
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the effect of Child Health Insurance access on schooling evidence from public Insurance expansions
Journal of Human Resources, 2016Co-Authors: Sarah Cohodes, Daniel S Grossman, Samuel A Kleiner, Michael F LovenheimAbstract:Although a sizable literature analyzes the effects of public Health Insurance programs on short-run Health outcomes, little prior work has examined their long-term effects. We examine the effects of public Insurance expansions among Children in the 1980s and 1990s on their future educational attainment. We find that expanding Health Insurance coverage for low-income Children increases the rate of high school and college completion. These estimates are robust to only using federal Medicaid expansions and mostly are due to expansions that occur when the Children are not newborns. Our results indicate that the long-run benefits of public Health Insurance are substantial.
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the effect of Child Health Insurance access on schooling evidence from public Insurance expansions
National Bureau of Economic Research, 2014Co-Authors: Sarah Cohodes, Daniel S Grossman, Samuel A Kleiner, Michael F LovenheimAbstract:Public Health Insurance programs comprise a large share of federal and state government expenditures. Although a sizable literature analyzes the effects of these programs on Health care utilization and Health outcomes, little prior work has examined the long-term effects and resultant Health improvements on important outcomes, such as educational attainment. We contribute to filling this gap in the literature by examining the effects of the public Insurance expansions among Children in the 1980s and 1990s on their future educational attainment. Our findings indicate that expanding Health Insurance coverage for low-income Children increases the rate of high school completion and college completion. These estimates are robust to only using federal Medicaid expansions, and mostly are due to expansions that occur when the Children are older (i.e., not newborns). We present suggestive evidence that better Health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translates into better teen Health. Overall, our results indicate that the long-run benefits of public Health Insurance are substantial.
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the effect of Child Health Insurance access on schooling evidence from public Insurance expansions
2014Co-Authors: Sarah Cohodes, Samuel A Kleiner, Michael F Lovenheim, Daniel S GrossmanAbstract:Public Health Insurance programs comprise a large share of federal and state government expenditures. Although a sizable literature analyzes the effects of these programs on Health care utilization and Health outcomes, little prior work has examined the long-term effects and resultant Health improvements on important outcomes, such as educational attainment. We contribute to filling this gap in the literature by examining the effects of the public Insurance expansions among Children in the 1980s and 1990s on their future educational attainment. Our findings indicate that expanding Health Insurance coverage for low-income Children increases the rate of high school completion and college completion. These estimates are robust to only using federal Medicaid expansions, and mostly are due to expansions that occur when the Children are older (i.e., not newborns). We present suggestive evidence that better Health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translates into better teen Health. Overall, our results indicate that the long-run benefits of public Health Insurance are substantial.Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.
Allison Kempe - One of the best experts on this subject based on the ideXlab platform.
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changes in access utilization and quality of care after enrollment into a state Child Health Insurance plan
Pediatrics, 2005Co-Authors: Allison Kempe, Brenda L Beaty, Lori A Crane, Johan Stokstad, Jennifer Barrow, Shira Belman, John F SteinerAbstract:Background. There currently are few published data evaluating the effect of State Children9s Health Insurance Programs on Health care outcome measures in Children. Colorado9s Child Health Plan Plus (CHP+) is a non-Medicaid State Children9s Health Insurance Program that began enrollment in April 1998. The objectives of this study were to compare reported (1) access to care, (2) utilization of Health care, and (3) quality of care during the year before and the first year after enrollment into CHP+. Methods. We interviewed 480 randomly selected families by telephone 2 months after their first enrollment into CHP+ (September 1999 to January 2000) and, again, 1 year later. We used generalized linear models to examine the effect of enrollment on Health care access, utilization, and quality while controlling for type of previous Insurance, length of time uninsured before enrollment, race/ethnicity, and age. Results. Regarding access to care, the percentage of families who reported a usual site of preventive care did not change significantly, but families reported more often being able to see providers as soon as desired for routine care (incidence ratio [IR]: 2.03; 95% confidence interval [CI]: 1.37–3.02]), for care when sick or injured (IR: 2.77; 95% CI: 1.85–4.16), for specialty care (IR: 1.96; 95% CI: 1.16–3.32), and for all Health care (IR: 2.35; 95% CI: 1.81–3.07). Unmet medical needs decreased after versus before enrollment for prescription medications (IR: 0.38; 95% CI: 0.26–0.55), mental Health care (IR: 0.63; 95% CI: 0.40–0.97), prescription glasses (IR: 0.44; 95% CI: 0.29–0.65), and dental care (IR: 0.59; 95% CI: 0.47–0.76). Regarding utilization, the proportion who saw a provider for routine care in the past year increased (IR: 1.39; 95% CI: 1.06–1.83), but reported visits for sick, specialty, and emergency department care and hospitalizations did not increase. Regarding quality of care, the proportion who rated their Health care as “best” increased (RI: 1.31; 95% CI: 1.04–1.66) after versus before enrollment. Conclusions. Families who were newly enrolled into CHP+ perceived dramatic increases in access to all types of care and decreases in unmet medical needs, no increase in utilization of emergency department or hospitalization services, and improved overall quality of care in the year after enrollment into CHP+.
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disenrollment from a state Child Health Insurance plan are families jumping s c hip
Ambulatory Pediatrics, 2004Co-Authors: Allison Kempe, Brenda L Beaty, Lori A Crane, Johan Stokstad, Jennifer Barrow, Shira Belman, John F SteinerAbstract:Background.—Colorado's Child Health Plan Plus (CHP+) is a non-Medicaid state Child Health plan that began enrollment in April 1998. Families are disenrolled 12 months after enrollment if they fail to re-enroll. Objective.—To assess Insurance coverage before and 1 year after initial enrollment in CHP+; reasons for disenrollment; and factors associated with re-enrollment. Design/Methods.—We interviewed 480 randomly selected families 2 months after initial enrollment into CHP+ (September 1999 through January 2000) and 1 year later. Results.—Prior to CHP+, 38% of families had Medicaid (MK), 35% were privately insured (PI), 6% were uninsured (UI), and 20% had other/unknown Insurance. After the 12 months, 34% were re-enrolled, 16% got other Insurance (6% MK, 10% PI/other), 4% had Children older than 18 years, and 46% were UI (9% had intentionally and 37% had unintentionally disenrolled from CHP+). All unintentionally disenrolled families were planning to re-enroll and 90% still appeared eligible. In multivariate analysis, having a primary care provider prior to enrollment was associated with re-enrollment (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1 to 2.6), but having problems with the application process impeded re-enrollment (OR 0.7, 95% CI 0.6 to 0.9). Conclusions.—Only about a third of families eligible for State Children's Health Insurance Program successfully re-enrolled before their termination date. Institution of a passive renewal process would decrease unnecessary disenrollment in eligible families.
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the first 2 years of a state Child Health Insurance plan whom are we reaching
Pediatrics, 2003Co-Authors: Allison Kempe, Jennifer Barrow, Brenda L Renfrew, Darci Cherry, Arnold H Levinson, John F SteinerAbstract:Objective. The Colorado Child Health Plan Plus is a non-Medicaid state Child Health Insurance Plan. The objective of this study was to compare early enrolling (EE) Children with uninsured Children in low-income families (ULI) with respect to 1) sociodemographic factors and previous Insurance, 2) Health status, and 3) previous Health care access and utilization. Methods. Cross-sectional telephone surveys were conducted during 1999 of 1) randomly selected EE Children (n = 711) and 2) ULI Children identified by random-dial survey (n = 105). Results. Enrolling Children were less likely to be Hispanic (32.7% vs 55.2%); 5.5% of EE versus 27.6% of ULI Children had never been insured. Prevalence of chronic conditions was similar (16.2% of EE vs 13.5% of ULI Children), but learning/behavioral difficulties (9.7% of EE vs 18.6% of ULI) and fair/poor Health (5.4% of EE vs 17.2% of ULI) were higher for uninsured Children. In the previous year, 88.2% of EE versus 66.1% of ULI Children had a usual source of care. The mean number of preventive visits was similar (1.4 vs 1.2), but the EE group reported a higher mean number of sick visits (2.0 vs 1.1), emergency visits (0.48 vs 0.15), and hospitalizations (0.09 vs 0.02). Conclusions. In the first 2 years of the program, Child Health Plan Plus is not yet reaching the “hard-to-reach” but, rather, disproportionately high numbers of non-Hispanic Children who already have a usual source of care and recent Insurance. EE Children did not have higher rates of chronic conditions but did demonstrate higher utilization before enrollment, possibly reflecting patterns of enrollment into the program.
Sarah Cohodes - One of the best experts on this subject based on the ideXlab platform.
-
the effect of Child Health Insurance access on schooling evidence from public Insurance expansions
Journal of Human Resources, 2016Co-Authors: Sarah Cohodes, Daniel S Grossman, Samuel A Kleiner, Michael F LovenheimAbstract:Although a sizable literature analyzes the effects of public Health Insurance programs on short-run Health outcomes, little prior work has examined their long-term effects. We examine the effects of public Insurance expansions among Children in the 1980s and 1990s on their future educational attainment. We find that expanding Health Insurance coverage for low-income Children increases the rate of high school and college completion. These estimates are robust to only using federal Medicaid expansions and mostly are due to expansions that occur when the Children are not newborns. Our results indicate that the long-run benefits of public Health Insurance are substantial.
-
the effect of Child Health Insurance access on schooling evidence from public Insurance expansions
National Bureau of Economic Research, 2014Co-Authors: Sarah Cohodes, Daniel S Grossman, Samuel A Kleiner, Michael F LovenheimAbstract:Public Health Insurance programs comprise a large share of federal and state government expenditures. Although a sizable literature analyzes the effects of these programs on Health care utilization and Health outcomes, little prior work has examined the long-term effects and resultant Health improvements on important outcomes, such as educational attainment. We contribute to filling this gap in the literature by examining the effects of the public Insurance expansions among Children in the 1980s and 1990s on their future educational attainment. Our findings indicate that expanding Health Insurance coverage for low-income Children increases the rate of high school completion and college completion. These estimates are robust to only using federal Medicaid expansions, and mostly are due to expansions that occur when the Children are older (i.e., not newborns). We present suggestive evidence that better Health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translates into better teen Health. Overall, our results indicate that the long-run benefits of public Health Insurance are substantial.
-
the effect of Child Health Insurance access on schooling evidence from public Insurance expansions
2014Co-Authors: Sarah Cohodes, Samuel A Kleiner, Michael F Lovenheim, Daniel S GrossmanAbstract:Public Health Insurance programs comprise a large share of federal and state government expenditures. Although a sizable literature analyzes the effects of these programs on Health care utilization and Health outcomes, little prior work has examined the long-term effects and resultant Health improvements on important outcomes, such as educational attainment. We contribute to filling this gap in the literature by examining the effects of the public Insurance expansions among Children in the 1980s and 1990s on their future educational attainment. Our findings indicate that expanding Health Insurance coverage for low-income Children increases the rate of high school completion and college completion. These estimates are robust to only using federal Medicaid expansions, and mostly are due to expansions that occur when the Children are older (i.e., not newborns). We present suggestive evidence that better Health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translates into better teen Health. Overall, our results indicate that the long-run benefits of public Health Insurance are substantial.Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.
Jennifer Barrow - One of the best experts on this subject based on the ideXlab platform.
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changes in access utilization and quality of care after enrollment into a state Child Health Insurance plan
Pediatrics, 2005Co-Authors: Allison Kempe, Brenda L Beaty, Lori A Crane, Johan Stokstad, Jennifer Barrow, Shira Belman, John F SteinerAbstract:Background. There currently are few published data evaluating the effect of State Children9s Health Insurance Programs on Health care outcome measures in Children. Colorado9s Child Health Plan Plus (CHP+) is a non-Medicaid State Children9s Health Insurance Program that began enrollment in April 1998. The objectives of this study were to compare reported (1) access to care, (2) utilization of Health care, and (3) quality of care during the year before and the first year after enrollment into CHP+. Methods. We interviewed 480 randomly selected families by telephone 2 months after their first enrollment into CHP+ (September 1999 to January 2000) and, again, 1 year later. We used generalized linear models to examine the effect of enrollment on Health care access, utilization, and quality while controlling for type of previous Insurance, length of time uninsured before enrollment, race/ethnicity, and age. Results. Regarding access to care, the percentage of families who reported a usual site of preventive care did not change significantly, but families reported more often being able to see providers as soon as desired for routine care (incidence ratio [IR]: 2.03; 95% confidence interval [CI]: 1.37–3.02]), for care when sick or injured (IR: 2.77; 95% CI: 1.85–4.16), for specialty care (IR: 1.96; 95% CI: 1.16–3.32), and for all Health care (IR: 2.35; 95% CI: 1.81–3.07). Unmet medical needs decreased after versus before enrollment for prescription medications (IR: 0.38; 95% CI: 0.26–0.55), mental Health care (IR: 0.63; 95% CI: 0.40–0.97), prescription glasses (IR: 0.44; 95% CI: 0.29–0.65), and dental care (IR: 0.59; 95% CI: 0.47–0.76). Regarding utilization, the proportion who saw a provider for routine care in the past year increased (IR: 1.39; 95% CI: 1.06–1.83), but reported visits for sick, specialty, and emergency department care and hospitalizations did not increase. Regarding quality of care, the proportion who rated their Health care as “best” increased (RI: 1.31; 95% CI: 1.04–1.66) after versus before enrollment. Conclusions. Families who were newly enrolled into CHP+ perceived dramatic increases in access to all types of care and decreases in unmet medical needs, no increase in utilization of emergency department or hospitalization services, and improved overall quality of care in the year after enrollment into CHP+.
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disenrollment from a state Child Health Insurance plan are families jumping s c hip
Ambulatory Pediatrics, 2004Co-Authors: Allison Kempe, Brenda L Beaty, Lori A Crane, Johan Stokstad, Jennifer Barrow, Shira Belman, John F SteinerAbstract:Background.—Colorado's Child Health Plan Plus (CHP+) is a non-Medicaid state Child Health plan that began enrollment in April 1998. Families are disenrolled 12 months after enrollment if they fail to re-enroll. Objective.—To assess Insurance coverage before and 1 year after initial enrollment in CHP+; reasons for disenrollment; and factors associated with re-enrollment. Design/Methods.—We interviewed 480 randomly selected families 2 months after initial enrollment into CHP+ (September 1999 through January 2000) and 1 year later. Results.—Prior to CHP+, 38% of families had Medicaid (MK), 35% were privately insured (PI), 6% were uninsured (UI), and 20% had other/unknown Insurance. After the 12 months, 34% were re-enrolled, 16% got other Insurance (6% MK, 10% PI/other), 4% had Children older than 18 years, and 46% were UI (9% had intentionally and 37% had unintentionally disenrolled from CHP+). All unintentionally disenrolled families were planning to re-enroll and 90% still appeared eligible. In multivariate analysis, having a primary care provider prior to enrollment was associated with re-enrollment (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1 to 2.6), but having problems with the application process impeded re-enrollment (OR 0.7, 95% CI 0.6 to 0.9). Conclusions.—Only about a third of families eligible for State Children's Health Insurance Program successfully re-enrolled before their termination date. Institution of a passive renewal process would decrease unnecessary disenrollment in eligible families.
-
the first 2 years of a state Child Health Insurance plan whom are we reaching
Pediatrics, 2003Co-Authors: Allison Kempe, Jennifer Barrow, Brenda L Renfrew, Darci Cherry, Arnold H Levinson, John F SteinerAbstract:Objective. The Colorado Child Health Plan Plus is a non-Medicaid state Child Health Insurance Plan. The objective of this study was to compare early enrolling (EE) Children with uninsured Children in low-income families (ULI) with respect to 1) sociodemographic factors and previous Insurance, 2) Health status, and 3) previous Health care access and utilization. Methods. Cross-sectional telephone surveys were conducted during 1999 of 1) randomly selected EE Children (n = 711) and 2) ULI Children identified by random-dial survey (n = 105). Results. Enrolling Children were less likely to be Hispanic (32.7% vs 55.2%); 5.5% of EE versus 27.6% of ULI Children had never been insured. Prevalence of chronic conditions was similar (16.2% of EE vs 13.5% of ULI Children), but learning/behavioral difficulties (9.7% of EE vs 18.6% of ULI) and fair/poor Health (5.4% of EE vs 17.2% of ULI) were higher for uninsured Children. In the previous year, 88.2% of EE versus 66.1% of ULI Children had a usual source of care. The mean number of preventive visits was similar (1.4 vs 1.2), but the EE group reported a higher mean number of sick visits (2.0 vs 1.1), emergency visits (0.48 vs 0.15), and hospitalizations (0.09 vs 0.02). Conclusions. In the first 2 years of the program, Child Health Plan Plus is not yet reaching the “hard-to-reach” but, rather, disproportionately high numbers of non-Hispanic Children who already have a usual source of care and recent Insurance. EE Children did not have higher rates of chronic conditions but did demonstrate higher utilization before enrollment, possibly reflecting patterns of enrollment into the program.