Address correspondence to Jill Boylston Herndon, Ph.D., Research Associate Professor, Department of Epidemiology and Health Policy Research and Institute for Child Health Policy, University of Florida, PO Box 100177, Gainesville, FL 32610-0177; e-mail: firstname.lastname@example.org. W. Bruce Vogel, Ph.D., Associate Professor, is with the Department of Epidemiology and Health Policy Research and Institute for Child Health Policy, University of Florida, Gainesville, FL. Dr. Vogel is also Research Health Scientist at the Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, Gainesville, FL. Richard L. Bucciarelli, M.D., Professor, is with the Department of Pediatrics, and Institute for Child Health Policy, University of Florida, Gainesville, FL. Elizabeth A. Shenkman, Ph.D., Professor, is with the Department of Epidemiology and Health Policy Research, Department of Pediatrics, and Institute for Child Health Policy, University of Florida, Gainesville, FL.
The Effect of Renewal Policy Changes on SCHIP Disenrollment
Article first published online: 3 JUN 2008
© Health Research and Educational Trust
Health Services Research
Volume 43, Issue 6, pages 2086–2105, December 2008
How to Cite
Herndon, J. B., Vogel, W. B., Bucciarelli, R. L. and Shenkman, E. A. (2008), The Effect of Renewal Policy Changes on SCHIP Disenrollment. Health Services Research, 43: 2086–2105. doi: 10.1111/j.1475-6773.2008.00866.x
- Issue published online: 12 NOV 2008
- Article first published online: 3 JUN 2008
- public health insurance;
- renewal policies;
Objective. To examine the impact of changing from a passive renewal process to an active renewal process in Florida's State Children's Health Insurance Program (SCHIP) on disenrollment.
Data Sources. Administrative records, containing enrollment and demographic data, were used to identify 414,396 enrollment spells from January 2004 through February 2006. Health care claims data were used to classify the children's health status.
Study Design. A Cox proportional hazards model was used to analyze the impact of changing to an active renewal process on the children's risk of disenrolling, controlling for the children's sociodemographic characteristics. Differential effects of the policy change by the children's health status were examined, and transfers to other public health insurance programs were taken into account.
Principal Findings. Children faced almost a 10-fold greater risk of disenrolling in their renewal month under active renewal than under passive renewal. We did not detect differential impacts of the policy change across children with different health status levels.
Conclusions. The switch to an active renewal process in Florida's SCHIP significantly increased disenrollment rates, and the effect of this policy change does not appear to vary by health status.