title: The use of EPSDT and other health care services by children enrolled in Medicaid: the impact of OBRA'89.
abstract: To increase the participation of Medicaid children in the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program and to improve their health, Congress included several provisions in the Omnibus Budget Reconciliation Act of 1989 (OBRA'89) that addressed problematic program features. The impact of these provisions on children's health service use was investigated in a study funded by the Health Care Financing Administration. After conducting site visits to four states, the authors analyzed claims data for the children residing there and found evidence that, in 1992, these states placed a higher priority on improving the effectiveness of EPSDT than they did before 1989. The states' efforts to expand the EPSDT provider base and to enhance outreach and service provision were either directly or indirectly inspired by OBRA'89. The authors also found evidence of a significant impact on provider participation and caseloads and on children's use of both preventive care and diagnostic and treatment services. However, the effects were modest in comparison to the size of the progress that is required.
authors.affiliation: Research Triangle Institute, USA.
authors.forename: N I
authors.initials: NI
authors.lastname: Gavin
authors.forename: E K
authors.initials: EK
authors.lastname: Adams
authors.forename: E J
authors.initials: EJ
authors.lastname: Herz
authors.forename: A J
authors.initials: AJ
authors.lastname: Chawla
authors.forename: M R
authors.initials: MR
authors.lastname: Ellwood
authors.forename: I T
authors.initials: IT
authors.lastname: Hill
authors.forename: B L
authors.initials: BL
authors.lastname: Zimmerman
authors.forename: J
authors.initials: J
authors.lastname: Wasserman
mesh_terms: D002017:Budgets; D002140:California; D002648:Child; D002662:Child Health Services / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D003752:Dental Health Services / Q000706:statistics & numerical data; D004608:Eligibility Determination / Q000706:statistics & numerical data; D005845:Georgia; D005102:Health Expenditures / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008403:Mass Screening / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008484:Medicaid / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008824:Michigan; D011314:Preventive Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013714:Tennessee; D014481:United States