Lee MA, Learned A; Academy for Health Services Research and Health Policy. Meeting.

Abstr Acad Health Serv Res Health Policy Meet. 2002; 19: 24.

Children's Health Council, 60 Gillett Street Suite 204, Hartford, CT 06105; Tel: (860) 548-1661; Fax: (860) 548-1783; E-mail: malee@hfpg.org

RESEARCH OBJECTIVE: The objective of this study was to evaluate the effectiveness of an intervention aimed at increasing timely well-child care for children in state custody enrolled in Connecticut's Medicaid managed care program. STUDY DESIGN: Prospective cohort study, using Medicaid managed care enrollment and encounter data. Each calendar quarter, children who were due for well-child visits were identified for health plans. Encounter data were then used to determine the percentage of these children who actually received timely well-child care (EPSDT on-time visit rate). In July 2000, the protective services agency introduced health care advocates to work with foster care and adoptive families. For the purpose of this study, the relative effectiveness of systematic, intensified outreach and follow-up by health care advocates was determined by comparing EPSDT on-time visit rates before and after the intervention for children in state custody and other children enrolled in the program. POPULATION STUDIED: Children under 19 enrolled in Medicaid managed care (approximately 45,000 children per quarter since 1999, including about 1,800 children in state custody). PRINCIPAL FINDINGS: On average, one in three children received a timely, well-child visit each quarter since monitoring began. Overall, the on-time visit rate varied significantly by age, with younger children consistently more likely than older children to have timely well-child care. The rate also varied by health plan and varied seasonally, especially among school-aged children. Prior to the introduction of an intensified program of outreach and follow-up, on-time visit rates for children in state custody were consistently five to ten percentage points lower than overall rates for the program; however, in the third quarter 2000, the gap began to narrow. The EPSDT on-time visit rate for children in state custody has now surpassed and remained higher than the overall rate for the program (39.5%, compared to 36.1% overall in the second quarter 2001). This difference is evident in every age group and is particularly noteworthy among adolescents. CONCLUSIONS: Well-child visit rates for children in state custody have improved significantly since the introduction of systematic, intensified outreach and follow-up. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Administrative data from a Medicaid managed care program can be used effectively to direct outreach and to evaluate interventions aimed at increasing utilization of well-child care. PRIMARY FUNDING SOURCE: Connecticut Department of Social Services

Publication Types:

• Meeting Abstracts

Keywords:

• Adolescent
• Child
• Child Health Services
• Child, Exceptional
• Cohort Studies
• Connecticut
• Humans
• Longitudinal Studies
• Managed Care Programs
• Medicaid
• Prospective Studies
• economics
• hsrmtgs

Other ID:

• GWHSR0002416

UI: 102274092

From Meeting Abstracts