• Deena J Chisolm, Sean P Gleeson, Kelly J Kelleher, Marisa E Domino, Emily Alexy, Wendy Yi Xu, and Paula H Song.
• Department of Pediatrics, The Ohio State University College of Medicine, 700 Children's Drive, RM FB3322, Columbus, OH 43205. Email: Deena.Chisolm@NationwideChildrens.org.
• Am J Manag Care. 2019 Mar 1; 25 (3): 114-118.

ObjectivesTo describe the extent and implications of "churn" between different Medicaid eligibility classifications in a pediatric population: (1) aged, blind, and disabled (ABD) Medicaid eligibility, determined by disability status and family income; and (2) Healthy Start Medicaid eligibility, determined by family income alone.Study DesignAs a result of a 2013 policy change, children with ABD eligibility transitioned from fee-for-service to capitated care. We used Ohio Medicaid claims data from July 2013 through June 2015 to explore the relationships among instability in eligibility category, demographics, and utilization.MethodsTo examine the potential financial effect of categorical churn, an effective capitation rate was created to capture the proportion of the maximum potential capitation rate that was realized.ResultsMore than 20% of children exited ABD-based eligibility at least once. Switching was associated with younger age and rural residence and was not associated with healthcare use.ConclusionsSwitching between eligibility categories is common and affects average capitation but not health service use.

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