WEST VIRGINIA
CHILDREN’S HEALTH INSURANCE PROGRAM
Presentation to the “KidStrong”
School Health Conference
June 9, 2011
Sharon L. Carte, Executive Director
WVCHIP IN 2011
Expanding to 300% FPL starting in August
 Annual Family Income Limits for WVCHIP



Family Size
CHIP
CHIP Premium
2
$29,420
$44,130
3
$37,060
$55,590
4
$44,700
$67,050
5
$52,340
$78,510
CHIP Premium is $35 per month per one child or $71
per month per two or more children
Full dental and vision now included in CHIP Premium
group
HEALTH CARE REFORM AND THE FUTURE –
WHAT HAPPENS TO CHIP?
2011
Exchange and Exchange Board Developed in State Code
2012
Streamlining of Medicaid and CHIP Eligibility
2013
Partnering to:
 Develop provider outreach for Exchange
 Oversee building and operation of Exchange as a
member of Exchange Board
HEALTH CARE REFORM AND THE FUTURE –
WHAT HAPPENS TO CHIP? -CONTINUED2014
Medicaid Expands Coverage to 133% FPL!
 About half CHIP’s enrollees now qualify for Medicaid, and so do
their parents!
 Parents of CHIP’s other half of enrollees may seek coverage
through the Exchange
2015


2016
Assess how children generally are accessing health coverage
through the Exchange
Specifically, how well are CHIP children and their parents
accessing health coverage?
Congress will re-evaluate the role of CHIP when it must reappropriate additional funding
CHIP AND BMS PARTNERING IN THE CMS
PEDIATRIC QUALITY DEMONSTRATION GRANT
 CMS
awarded 10 grants nationally to study child
health quality issues in 2010
 The
states of Oregon, Alaska, and West Virginia were
awarded one of these grants for a five year period
 In
2011, WVCHIP and BMS are beginning to report on
a statewide set of quality measures drawn from the
national set of 24 measures
CHIP AND BMS PARTNERING IN THE CMS
PEDIATRIC QUALITY DEMONSTRATION GRANT

-CONTINUED-
In West Virginia, eight pediatric practices have been recruited
to examine and assess:
 The impact of Person Centered Medical Home (PCMH) on
child health quality
 EHR/PHR usefulness to child health quality
 Full-time care coordination provided in these practices
 Examine the usefulness of the 24 measures of child health
data set at a practice level