The effect of renewal policy changes on SCHIP disenrollment.
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.


METHODS
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.


METHODS
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.


RESULTS
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.
Department of Epidemiology and Health Policy Research and Institute for Child Health Policy, University of Florida, PO Box 100177, Gainesville, FL 32610-0177, USA. jbh@ichp.ufl.edu
Jill Boylston
JB
Herndon
W Bruce
WB
Vogel
Richard L
RL
Bucciarelli
Elizabeth A
EA
Shenkman
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000191:economics; D002675:Child, Preschool; D016208:Databases, Factual; D004608:Eligibility Determination / Q000458:organization & administration*; D005260:Female; D005431:Florida; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000458:organization & administration*; D007348:Insurance, Health / Q000191:economics*; D016134:Organizational Policy; D016016:Proportional Hazards Models; D012959:Socioeconomic Factors; D013221:State Health Plans / Q000191:economics*; D014481:United States