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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Adequate Insurance.

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Strategy. CHIP

Approach. Support the enrollment of children in the Children’s Health Insurance Program (CHIP) across the state

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Overview. The Children’s Health Insurance Program (CHIP) is a public benefits program exclusively for uninsured children whose family income is too high for Medicaid. CHIP, financed jointly by the federal government and individual states and administered by the states, insures over 8 million children.[1] The Patient Protection and Affordable Care Act of 2010 (ACA) contains provisions to strengthen coverage for children under CHIP, including requirements to conduct outreach and enrollment of populations with additional health needs including children and youth with special health care needs.

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Outreach and awareness campaign activities
  • Training and capacity building for enrollment partners
  • Data sharing and coordination with partner agencies

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Community Health Factors.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of outreach events or campaigns conducted to educate families about CHIP eligibility and benefits. (Measures efforts to raise awareness and promote enrollment)
  • Number of partnerships established with schools, community organizations, and healthcare providers to identify and refer eligible children to CHIP. (Shows the breadth of community partner engagement in outreach)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of potentially eligible children who are enrolled in CHIP. (Shows the program's penetration and success in reaching the focus population)
  • Percent of CHIP applications that are accurately processed within the state's standard timeframe. (Assesses the efficiency and responsiveness of the enrollment system)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of trainings provided to CHIP outreach workers and application assisters on best practices for engaging and enrolling various populations. (Builds workforce capacity for effective outreach)
  • Number of quality improvement initiatives implemented by CHIP health plans to enhance access and quality of care for enrolled children. (Drives system-level enhancements)
  • Number of emergency department visits and hospitalizations prevented among CHIP enrollees due to better access to preventive and primary care. (Demonstrates the potential for cost savings)
  • Number of school days attended by children enrolled in CHIP who previously missed school due to untreated health conditions. (Reflects the program's impact on child well-being and academic success)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of eligible but unenrolled children who are successfully contacted and assisted with CHIP enrollment. (Measures the effectiveness of tailored outreach to those most in need)
  • Percent of CHIP enrollees that are retained in coverage for at least 12 continuous months. (Shows the stability of coverage and protection against gaps in care)
  • Percent reduction in the uninsured rate among eligible children after CHIP outreach and enrollment efforts. (Demonstrates population-level impact on coverage)
  • Percent decrease in child conditions commonly identified and treated through CHIP (e.g., asthma, ADHD, dental caries). (Reflects the program's impact on health)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs. CHIP Financing Strategy.
https://ciswh.org/project/the-catalyst-center/financing-strategy/chip/

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.