SHADAC Expertise

Coordinated State Coverage Survey (CSCS)

The Coordinated State Coverage Survey (CSCS) is a survey instrument developed by SHADAC to measure state-level health insurance coverage rates.

About the CSCS

The Coordinated State Coverage Survey (CSCS) is:

• A household telephone survey instrument developed by SHADAC researchers
• Specially designed to monitor the uninsured and provide reliable state-level insurance coverage estimates to inform state health policies, unlike national survey instruments

To date, nearly 20 states have used, or are using, the CSCS to collect state-specific data on the uninsured.

Components of the CSCS

The CSCS consists of two main components: the core and the state-added questions.

• The core includes questions on health insurance coverage and demographics. Optional items in the core are designed to assess potential access to health insurance coverage through family members or employers

• State-added questions reflect changes to the CSCS per the informational needs of the states. States have included questions on topics such as willingness to pay (Indiana 2003), concerns about loss of coverage (Alabama 2003; Oklahoma 2004), dental coverage (Alabama 2003), attitudes toward and awareness of state reforms (Massachusetts, 2008) and Medicare supplemental policies (Minnesota 2004, 2007)

Using the CSCS

The survey is available for public use, and SHADAC researchers are available to assist states in customizing the study design. You may download a sample questionnaire (Minnesota 2011 in Word or PDF). Any questions on the content can be directed to Kathleen Call at SHADAC (612-625-2932 or

CSCS Content

The CSCS is designed to achieve concise estimates of health insurance coverage by:

• Targeting primary residences using county identifiers

• Establishing contact with the person in the household most knowledgeable about health insurance

• Enumerating who is in the household

• Selecting one "target" person at random

• Establishing the relationship of the target to all other household members

• Determining the target's current and prior year (annual) health insurance coverage

• Obtaining current health insurance coverage info of all other household members (optional but recommended)

Based on annual insurance status, target respondents are sorted into the following groups:

1. Employer-based insurance all year

2. Individual coverage all year

3. Uninsured all year

4. Period of no insurance during the past 12 months

5. All others

The CSCS also includes additional questions specifically designed for these groups.

CSCS Description

CSCS Flowchart

States Using the CSCS

  State   Year(s)
  Alabama   2003
  Colorado   2001, 2008
  Connecticut   2001, 2004
  Georgia   2002
  Indiana   2003
  Maine   2002
  Minnesota   2001, 2004, 2007, 2009
  Massachusetts   2008
  Missouri   2004
  Montana   2003
  North Dakota   2004
  Nebraska   2004
  Oklahoma   2004, 2008
  Pennsylvania   2004
  South Carolina   2003
  Tennessee   2005
  Virgin Islands   2003, 2009
  Virginia   2004
  West Virginia   2001
  Wyoming   2002