Managing access: extending Medicaid to children through school-based HMO coverage.
Coulam, Robert F
Date of Pub
Calore, Kathleen A; Irvin, Carol V; Kidder, David; Rosenbach, Margo L
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.
Health Services Accessibility : Child : Child Health Services/economics/utilization : Eligibility Determination : Emergency
Service, Hospital/utilization : Florida : Health Care Costs : Health Care Surveys : Health Maintenance Organizations/economics/utilization
: Health Services Needs and Demand : Human : Medicaid/statistics & numerical data/utilization : Medical Indigency : Pilot
Projects : Poverty : School Health Services/economics/utilization : Support, U.S. Gov't, P.H.S. : United States