Managed Care Quality of Care and Plan Choice in New York SCHIP

Published In: HSR, Health Services Research, v. 44, no. 3, June 2009, p. 843-861

Posted on RAND.org on June 01, 2009

by Harry H. Liu, Charles E. Phelps, Peter J Veazie, Andrew W. Dick, Jonathan D. Klein, Laura P. Shone, Katia Noyes, Peter G. Szilagyi

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OBJECTIVE: To examine whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care. DATA SOURCES: 2001 New York SCHIP evaluation data; 2001 New York State Managed Care Plan Performance Report; 2000 New York State Managed Care Enrollment Report. STUDY DESIGN: Each market was defined as a county. A final sample of 2,325 new enrollees was analyzed after excluding those in markets with only one SCHIP plan. Plan quality was measured using seven Consumer Assessment of Health Plans Survey (CAHPS) and three Health Plan Employer Data and Information Set (HEDIS) scores. A conditional logit model was applied with plan and individual/family characteristics as covariates. PRINCIPLE FINDINGS: There were 30 plans in the 45 defined markets. The choice probability increased 2.5 percentage points for each unit increase in the average CAHPS score, and the association was significantly larger in children with special health care needs. However, HEDIS did not show any statistically significant association with plan choice. CONCLUSIONS: Low-income parents do choose managed care plans with higher CAHPS scores for their newly enrolled children, suggesting that overall quality could improve over time because of the dynamics of enrollment.

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