title: Managing access: extending Medicaid to children through school-based HMO coverage.
abstract: This study explores how a health maintenance organization's (HMO) capacity and incentives to manage care might be used to improve access. In the early 1990s, the Florida Healthy Kids (FHK) demonstration extended Medicaid-like HMO coverage to indigent children in the public schools of Volusia County, Florida. The study finds that uninsured student months in area public schools were likely reduced by one-half. Utilization and cost levels for these indigent enrollees proved to be indistinguishable from commercial clients; and measures of access, utilization, and satisfaction for enrollees were in line with (and in some cases, superior to) non-enrollees with private insurance. Overall, these results suggest the value of using schools as a medium for providing coverage, and the importance of taking deliberate steps to manage access to reduce non-financial barriers to care.
authors.affiliation: Abt Associates Inc., USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Coulam
authors.forename: C V
authors.initials: CV
authors.lastname: Irvin
authors.forename: K A
authors.initials: KA
authors.lastname: Calore
authors.forename: D E
authors.initials: DE
authors.lastname: Kidder
authors.forename: M L
authors.initials: ML
authors.lastname: Rosenbach
mesh_terms: D002648:Child; D002662:Child Health Services / Q000191:economics* / Q000706:statistics & numerical data; D004608:Eligibility Determination; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005431:Florida; D017048:Health Care Costs; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data*; D008489:Medical Indigency; D010865:Pilot Projects; D011203:Poverty; D012572:School Health Services / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States