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Key Findings:

• Planning and operations. Medicaid and CHIP administrators in most of the study states began planning at least six months before the transition and involved agency staff, health insurance issuers, child health advocates, and provider groups in the planning discussions.
• Continuity of care. Administrators in 4 of the 10 states proactively addressed continuity of care issues by either helping children enroll in a Medicaid health plan in which their existing primary care provider participated or encouraging separate CHIP primary care providers to accept Medicaid.
• Challenges. The most common challenges state administrators faced when undertaking the transition related to technology, the administrative burden of simultaneously implementing other ACA-related policy changes, and educating families and providers about the transition.
• Best practices for ensuring smooth transitions. State administrators believe that several factors contributed to smooth transitions for children and families, including close coordination within and across Medicaid and separate CHIP teams; clear and consistent communication with families, health insurance issuers, providers, and other stakeholders; and implementation of policies that ensure continuity of care.