title: SCHIP structure and children's use of care.
abstract: This study explores the impact of program structure on children's use of care by comparing care use in State Children's Health Insurance Program (SCHIP) and Medicaid covered populations in a State where children share the same provider network and are both in a primary care case management system with the same Medicaid fee structure. We then compare care use in this system to care use in an SCHIP structured as a fee-for-service (FFS) system using a private insurance provider network and fee schedule. Where SCHIP and Medicaid Programs share a primary care case management (PCCM) system, we find more use of well-child care among Medicaid covered children, but more use of office-based physician care among SCHIP covered children. Across the Medicaid PCCM-based and the private insurance FFS-based system, we find more use of primary and specialty care in the FFS system, and more use of well-child care and less use of emergency departments for non-urgent care in the PCCM-based system.
authors.affiliation: University of Alabama, School of Public Health, Birmingham 35294-0022, USA. jbronste@uab.edu
authors.forename: Janet M
authors.initials: JM
authors.lastname: Bronstein
authors.forename: E Kathleen
authors.initials: EK
authors.lastname: Adams
authors.forename: Curtis S
authors.initials: CS
authors.lastname: Florence
mesh_terms: D000293:Adolescent; D000385:Aid to Families with Dependent Children; D000407:Alabama; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D018588:Fee-for-Service Plans; D017144:Focus Groups; D005845:Georgia; D006801:Humans; D007223:Infant; D008484:Medicaid / Q000458:organization & administration*; D013219:State Government; D014481:United States