Management tools for Medicaid and State Children's Health Insurance Program (SCHIP)

W. Pete Welch, Barbara A. Rudolph, Lynn A. Blewett, Stephen T. Parente, Cindy Brach, Denise Love, Robert G. Harmon

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Medicaid and the State Children's Health Insurance Program need analytic tools to manage their programs. Drawing upon extensive discussions with experts in states, this article describes the state of the art in tool use, making several observations: (1) Several states have linked Medicaid/State Children's Health Insurance Program administrative data to other data (eg, birth and death records) to measure access to care. (2) Several states use managed care encounter data to set payment rates. (3) The analysis of pharmacy claims data appears widespread. The article also describes "lessons learned" regarding building capacity and improving data to support the implementation of management tools.

Original languageEnglish (US)
Pages (from-to)272-282
Number of pages11
JournalJournal of Ambulatory Care Management
Volume29
Issue number4
DOIs
StatePublished - Jan 1 2006

Keywords

  • Administrative data
  • Encounter data
  • Medicaid
  • SCHIP
  • Vital statistics

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