Case Study of Missouri: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice

This case study examines new enrollment trends from 1999 through late 2004 in Medicaid and SCHIP for children in Missouri. In particular, the study examines the relationship between new enrollment trends during this time frame and the major outreach strategies and policy changes that took place in Missouri. In order to look at this relationship during more recent time periods, for which data on new entries are not available, the study also examines overall trends in enrollment from 1994 through 2006. Ideally, we would examine the relationship between enrollment and policy by analyzing the impact of each outreach effort or policy change on Medicaid and SCHIP enrollments. This type of analysis is not possible, however, because many of the outreach efforts and policy changes occurred at the same time. In addition, no state or other geographic area is a defensible comparison group for a rigorous analysis. The case study approach, which combines exploratory data analysis with in-depth interviews, allows us to ascertain where and how CKF’s influence was most likely a factor and provides detailed information to complement the ongoing national evaluation of the CKF program.