Health Insurance Coverage

Covering Kids and Families (CKF), a national initiative funded by the Robert Wood Johnson Foundation, works through state and local coalitions to increase enrollment in public health insurance of uninsured, low-income children and adults. The program conducts outreach to children and families without coverage, simplifies enrollment and renewal processes, and coordinates existing health care coverage programs. Recent case studies from Mathematica’s evaluation of the CKF program include:

"Case Study of Arkansas: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice. Covering Kids and Families Evaluation." Jenna Walls, Bridget Lavin, Kathy Gifford, and Christopher Trenholm, July 2006. This case study discusses trends in new Medicaid and State Children’s Health Insurance Program (SCHIP) enrollment of children in Arkansas from 1999 through 2003. Researchers found that policy changes in Arkansas destigmatized public health insurance, leading to increased enrollment in both Medicaid and SCHIP.

"Case Study of Virginia: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice. Covering Kids and Families Evaluation." Embry Howell, Christopher Trenholm, Kathy Gifford, and Bridget Lavin, July 2006. This case study discusses trends in new Medicaid and SCHIP enrollment of children in Virginia from 1999 through 2003. Simplification of the enrollment process and coordination between Medicaid and SCHIP drove Virginia’s substantial gains in enrolling children into public insurance.

"Case Study of California: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice. Covering Kids and Families Evaluation." Jennifer Sullivan, Ian Hill, and Christopher Trenholm, July 2006. This case study discusses trends in new Medicaid and SCHIP enrollment of children in California from 1999 through 2003. During an economic downturn, when California expanded eligibility and simplified enrollment, the number of children enrolled in programs should have grown, but didn’t. Cutbacks in outreach appear to be an important cause.

"Case Study of New Jersey: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice. Covering Kids and Families Evaluation." Christopher Trenholm, Bridget Lavin, and Judith Wooldridge, May 2006. This case study discusses trends in new Medicaid and SCHIP enrollment of children in New Jersey from 1999 through 2003. New Jersey’s ambitious effort to insure children eligible for Medicaid or NJ FamilyCare was slowed by administrative difficulties.

Read more about this study.

Children's Diets

“Dietary Effects of Universal-Free School Breakfast: Findings from the Evaluation of the School Breakfast Program Pilot Project.” Mary Kay Crepinsek, Anita Singh, Lawrence S. Bernstein, and Joan E. McLaughlin, Journal of the American Dietetic Association, November 2006. This article reports on an experimental study to determine the effects on students’ dietary outcomes of offering universal-free school breakfast in elementary schools. Treatment schools offered free breakfasts to all students regardless of family income. Schools participating in the federal School Breakfast Program (SBP), which offers free or reduced-price breakfast for children from families below the poverty level, served as controls. More than 4,000 students in grades 2 through 6 provided 24-hour dietary recall data at the end of the first year. Despite a significant increase in school breakfast participation among students in treatment schools (from 16 percent to 40 percent), the rate of breakfast skipping did not differ between groups (4 percent overall). Treatment school students were more likely to eat breakfast at school and consume a nutritionally substantive breakfast, but dietary intakes over 24 hours were essentially the same. The authors conclude that making universal-free school breakfast available in elementary schools will not result in more students "breaking their fast" or improving the quality of their diet, beyond any effects of offering the regular SBP. To improve children’s diets overall, efforts should focus on ensuring that all students have access to a healthful breakfast, at home or at school.

Pay for Performance

“Pay for Performance: Are Hospitals Ready and Willing?” Suzanne Felt-Lisk and Mary Laschober, November 2006. Public and private payers are developing hospital care pay for performance (P4P) initiatives as part of a broader national movement to improve the quality and cost-effectiveness of health care services. These initiatives augment or reduce payments to a hospital on the basis of its performance on a predefined set of quality measures. This issue brief is based on Mathematica’s study that examined hospital public reporting of quality information. The study included a nationally representative survey of acute care hospitals in 2005 that asked about their participation in P4P programs and views on future quality initiatives. Researchers found that only about 20 percent of hospitals had participated in a P4P program but nearly all support moving ahead with a P4P strategy that would encompass most U.S. acute care hospitals.

GED and Labor Market Returns

Natives, the Foreign-Born, and High School Equivalents: New Evidence on the Returns to the GED.” Melissa A. Clark and David Jaeger, Journal of Population Economics, October 2006. This article explores the labor market returns to the General Education Development (GED) exam for U.S. natives and the foreign-born. The authors found that foreign-born men with a GED who received all of their formal schooling abroad earn significantly more than either foreign-schooled high school dropouts or graduates. In contrast, among U.S. natives, GED recipients earn less than high school graduates but significantly more than dropouts. The returns for natives become larger over the life cycle and are not due to cohort effects. The findings indicate that the GED may be more valuable in the labor market than some previous research suggests.