For the past two decades, an important focus of HSR's practice has been to work with public agencies at all levels of government, as well as concerned private-sector organizations, to develop policies and programs to extend coverage to persons who might otherwise be uninsured. Clients have included federal agencies, state legislative task forces, Governor's commissions, and public and private study groups.

HSR has a rich history of helping individual states improve the operations and effectiveness of their Medicaid programs. Over the years, we have worked with many states to review and evaluate the operation of their programs and to assist them in designing creative policies and strategies to enhance systems management. We have also conducted cross-cutting, multi-state studies and evaluations of policies, initiatives, and demonstrations for many government agencies and private foundations.

Enrollment for Medicaid and SCHIP

The Henry J. Kaiser Family Foundation commissioned HSR to conduct a study of Medicaid and SCHIP outreach enrollment systems. This in-depth analysis of four representative states looked at strategies for: publicizing Medicaid and SCHIP programs, identifying and referring potentially eligible families, and streamlining the process of eligibility determination.

Quality and Performance Measurement

Working for HCFA and AHRQ, HSR convened and facilitated a meeting designed to explore the potential for applying specific existing HEDIS measures to state-related health insurance programs for children.

Capitation Under Medicaid Managed Care

HSR recently conducted a study of state Medicaid programs' methods for developing managed care capitation rates, focusing on the population of AFDC and related eligibles in 15 states. The study, sponsored by the Henry J. Kaiser Family Foundation, looked at the entire process that these states followed in setting capitation rates, from the data they provided plans, through the negotiation process, to the specific quality assurance provisions they included in their contracts.

In addition, HSR has been extensively involved in the design, analysis and evaluation of a number of other important public programs and policies designed to improve vulnerable populations' access to needed care. These efforts include:

• Design, assessment and coordination of Medicaid and state Child Health Insurance Program (SCHIP) outreach efforts,
• Efforts to help safety net providers respond to and remain financially viable in today's rapidly changing health care marketplace, and
• Work with individual states to help them more efficiently integrate different programs offering health care coverage to low-income or disadvantaged persons.

For more information, please contact:

Renee Schwalberg, M.P.H.
Deputy Director, Maternal, Child and Community Health Division
Health Systems Research, Inc.
(207) 772-1410

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