Churning in Medicaid Managed Care and Its Effect on Accountability

Fairbrother, Gerry; Jain, Aparna; Park, Heidi L.; Massoudi, Mehran S.; Haidery, Arfana; Gray, Bradford H.

doi:10.1353/hpu.2004.0003

Cited by 30 publications

(21 citation statements)

References 5 publications

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“…77 Most states do not keep updated statistics on the proportion of renewals that take place, and so there is little information available on an ongoing basis about how many children lose coverage at renewal. 78 Also, past efforts to collect data on eligibility renewal outcomes indicate that states vary considerably in their capacity to report on renewal outcomes. Some state databases do not distinguish between cases closed at renewal and other case closures.…”

Section: Famis Famis Plusmentioning

confidence: 99%

Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences, and Remedies

Mann¹,

Summer²

2006

CMWF Fund Reports

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This report examines the extent, causes, and consequences of instability in public coverage programs for children and families. It focuses particularly on the phenomenon of "churning," which occurs when individuals lose and regain coverage in a short period of time. It also looks at strategies to make public program coverage more stable for children and families. Findings are drawn from a variety of sources, including national and state-based studies, roundtable discussions and interviews with stakeholders and experts, and an examination of the effect of state and local policies on instability and churning in four states: Louisiana, Rhode Island, Virginia, and Washington. The experiences of these states demonstrate that coverage instability can be averted to a significant degree by adopting key policies and procedures, like limiting the frequency of required renewals; developing easy, seamless transitions among public coverage programs; and setting affordable limits on premium costs. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This report and other Fund publications are available online at www.cmwf.org. To learn more about new publications when they become available, visit the Fund's Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 935.iii CONTENTS

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Section: Famis Famis Plusmentioning

confidence: 99%

Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences, and Remedies

Mann¹,

Summer²

2006

CMWF Fund Reports

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“…KEYWORDS: CHIP; insurance; Medicaid; retention ACADEMIC PEDIATRICS 2014;-: [1][2][3][4][5][6][7][8][9] WHAT'S NEW Three different metrics designed to assess public health insurance retention demonstrate high reproducibility by state and county for children. As health care reform unfolds, the complete set of these 3 metrics can inform multipronged and multilevel strategies to retain eligible children.…”

Section: Results: All 3 Metrics Demonstrated Reproducible Estimatesmentioning

confidence: 99%

Medicaid and CHIP Retention Among Children in 12 States

Pati¹,

Wong²,

Calixte³

et al. 2015

Academic Pediatrics

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“…7 Finally, gaps in coverage could affect quality of care, not only because care may be different in the gaps than the periods of insurance, but also because short tenures in care make it difficult to monitor patients effectively, and, if needed, institute corrective action. 8 Several studies have documented that up to half of the children in SCHIP are dropped at renewal periods. 9 Enrollment patterns for Medicaid children have been examined less frequently, despite the fact that Medicaid serves approximately five times as many children as SCHIP.…”

Section: R E C E N T S T U D I E S H Av E D O C U M E N T E D I N S Tmentioning

confidence: 99%

How Stable Is Medicaid Coverage For Children?

Fairbrother

Emerson²,

Partridge

2007

Health Affairs

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We examined Medicaid coverage patterns in five states for children who were covered as of December 2003. Looking back three years, we found that Medicaid was a source of continuous coverage for sizable proportions of children (43-66 percent were covered for two or more years) but a revolving door for others (16-41 percent had gaps). In all states, gaps were short, from two to four months. Continuity implies that states can demand more of the health care system to improve the quality of care; short gaps imply that policies and procedures should be revisited to reduce gaps for eligible children. R e c e n t s t u d i e s h av e d o c u m e n t e d i n s ta b i l i t y in health insurancefor a large proportion of the U.S. population: Approximately eighty-five million (or one in three) Americans were uninsured at some point between 1996 and 1999. During this same four years, more than 40 percent of children experienced a gap in coverage, and nearly half of those were repeatedly or continuously uninsured. These studies have shown that being insured and uninsured are not chronic states; rather, a sizable proportion of the population moves between them.

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Churning in Medicaid Managed Care and Its Effect on Accountability

Cited by 30 publications

References 5 publications

Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences, and Remedies

Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences, and Remedies

Medicaid and CHIP Retention Among Children in 12 States

How Stable Is Medicaid Coverage For Children?

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