(Answered) Health Care Program/Policy

State Children’s Health Insurance Program (SCHIP)

It is a comprehensive healthcare program developed to provide healthcare services for the growing number of uninsured children in the United States. The program was established under the Title XII of the Social Security Act of 1997 (Rosenbach et al., 2007).   This policy allows the states to create programs to ensure expanded access to affordable health insurance (Hoag et al., 2011).  The program began to become effective in 1999 (Adeyinka et al., 2019). It covers children and provides them with comprehensive healthcare through the age of 19. It targets children living in households with incomes at or below 247% of the Federal poverty level.

Based on the evaluation, it is evident that SCHIP reduced the number and rate of uninsured children from low-income families (Alker et al., 2020).  Through consistent time series of data, it was discovered that the proportion of uninsured children below 19 years between 1997 and 2003 reduced from 15.5% to 12.8% (Rosenbach et al., 2007).   It was also discovered that SCHIP ensured low-income children’s safety to protect them from the effects of the recession and any economic downturn (Alker et al., 2020).   Another program outcome was that SCHIP increased access to healthcare services (Hoag et al., 2011). The data showed that through SCHIP, children were likely to have improved usual sources of care, which led to the minimized level of unmet needs through enrolling in the SCHIP program.

The program’s success was measured by conducting various evaluation forms, including process evaluation, outcome evaluation, and impact evaluation (Adeyinka et al., 2019).   Process evaluation was carried out to measure the program’s success based on the effectiveness of the activities that have been implemented and whether the program has achieved the intended purpose (Hoag et al., 2011). Outcome evaluation was carried out to measure the impacts of SCHIP on enrolled children by assessing how it is progressing in outcome objectives that it was implemented to attain (Adeyinka et al., 2019).  Besides, the impact evaluation was carried out to measure the program’s success based on the effectiveness of attaining the ultimate targets. The evaluation entailed measuring the effects of SCHIP on the quality of healthcare services delivered to children and their outcomes (Rosenbach et al., 2007). The assessment was based on the program’s effects on enrollment and retention, access to healthcare, quality of care and satisfaction, and the long-term impacts among children from low-income backgrounds

Initially, the program targeted the general population, so there should be aware of SCHIP (Alker et al., 2020). However, they started to target only the eligible individuals enrolled in the SCHIP, including the minorities, rural residents, immigrants, and working families.  The vulnerable population was identified using different sources of data, including the SCHIP helpline data and the survey data. Around 17,000 children were targeted in Georgia because they were enrolled in Medicaid due to SCHIP outreach activities (Rosenbach et al., 2007).  The number of children estimated for the program was based on the count of PeachCare for Kids applications referred to Medicaid with the application of 51% approval rate.

State annual reports- the state children’s health insurance program (SCHIP) required states to submit annual reports indicating their progress toward meeting their objectives.

External studies-provided evidence for literature synthesis that was in line with substitution, retention, and access to care (Golding & Nicola, 2019). There was a thorough search for both published and unpublished information to find relevant studies with the literature synthesis.

The SCHIP statistical enrollment data system- the provisions in the enrollment system contain the income group for people, age group, and the delivery system, which provided information for the variety of enrollment trends (Rosenbach et al., 2007).

Georgia Medicaid Statistical Information System- within the Medicaid Statistical Information System, there are detailed and eligible data of the various programs on enrollee information of enrollment outcomes in Georgia.

Performance measures- based on the performance measures, there were data substantiated on the health measures of patients in Georgia, such as their visits to primary care providers, child visits, and the various medications.

Georgia’s current population survey- the population survey gave detailed estimates of insurance covers and the respective trends among children, young and older adults. Through the provisions in the data, an analysis could be done on the annual trends in private and public coverage.

One potential benefit of the policy evaluation was an improvement of the policy development, implementation, and effectiveness of the service, including necessary changes to improve the program delivery (Rosenbach et al., 2007). There was ease in getting to know the progress of the program and how well it was working. Based on the results, one potential unintended consequence of the healthcare policy was the huge gap between the rationality in theory and in practice as theory had a lot of data compared to what intervention process (Golding & Nicola, 2019). For example, a difference existed between the interactions on technology in the respective healthcare facilities in Georgia and the healthcare environment. In some cases, the alternatives to the policy were too complex for one to understand as there were cases of disenrollment of children from the program while they were still eligible.