A time series study of the effectiveness and costs of EPSDT outreach in Maine.
Maine's Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program provides outreach and case management services through written agreements with 13 community-based agencies. These agencies are reimbursed on a cost-related basis for contacting new and re-eligible Medicaid families to inform them about EPSDT services and to enroll children in the program. Since October 1979, local agency outreach workers have attempted to inform 95 percent of the eligible families in their own homes. Effectiveness was measured by comparing the percentages of families informed with the 95 percent Federal requirement. Concurrently, but separately, agency costs were monitored. The authors undertook a study to determine the unit costs of informing families for 4 years and to relate those costs to the percentages of families informed. Using a single group time series design combined with a cost-effectiveness model, both effectiveness and efficiency were examined. The percentage of families informed increased 7.8 percent from State Fiscal Year (SFY) 1980 through SFY 84. The percent of increase per year, however, has decreased from 3.42 percent to 1.29 percent. The statewide informing unit cost decreased from $51.19 to $45.34 during the same time period. Examination of individual agency unit costs indicates that the difference between the lowest and highest agency unit cost is becoming greater each year. This study has reaffirmed the authors' belief that personal contact with families increases the likelihood of enrolling children in the program; less than 3 percent of the families informed of EPSDT services declined them. The study also indicates that changes in program procedures, reimbursement, or both, are needed to increase further the effectiveness and efficiency of this aspect of the program.
Jones
E
E
Nickerson
J M
JM
D002648:Child; D002662:Child Health Services / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D002675:Child, Preschool; D003625:Data Collection; D005190:Family; D006801:Humans; D008281:Maine; D008484:Medicaid; D010043:Outcome and Process Assessment, Health Care; D013221:State Health Plans / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D013997:Time Factors; D014481:United States