title: Quality and cost evaluation of a medical financial assistance program.
abstract: BACKGROUND
  Kaiser Permanente Colorado has been responding to the financial challenges of its members by providing a medical financial assistance (MFA) program since 1992. However, there have been no evaluations of the effect of this program on members' use of health services or their health outcomes.
  
  
  METHODS
  A prospective cohort study of 308 MFA program members who were enrolled between May 16, 2008, and May 16, 2009, examined changes in their use of health services, costs, and self-reported physical and mental health after enrollment in the MFA program. Use of services was analyzed with multiple regression, and costs of services with generalized linear models.
  
  
  RESULTS
  MFA increased members' access to health services. There were no changes in physical or mental health status. For each health care visit before the MFA award, patients used the health care system 0.23 visits less. The MFA amount was not associated with an increase or decrease in use. There was no significant difference in total overall cost. Hospital costs were lower, but costs for clinic visits, pharmacy services, phone calls, and radiology services were significantly higher, resulting in service cost neutrality, possibly because financial barriers before MFA award led to accumulated demand for services.
  
  
  CONCLUSIONS
  Use of services decreased after MFA was received. There was no significant change in total service cost. MFA improved members' ability to pay for medical services and increased their satisfaction with health services.
authors.affiliation: Institute for Health Research in Denver, CO, USA. douglas.a.conner@kp.org
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Conner
authors.forename: Arne
authors.initials: A
authors.lastname: Beck
authors.forename: Christina
authors.initials: C
authors.lastname: Clarke
authors.forename: Leslie
authors.initials: L
authors.lastname: Wright
authors.forename: Komal
authors.initials: K
authors.lastname: Narwaney
authors.forename: Neysa W
authors.initials: NW
authors.lastname: Bermingham
mesh_terms: D000368:Aged; D019033:Delivery of Health Care, Integrated / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D006304:Health Status; D061889:Healthcare Financing; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014481:United States