Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Evaluating a Large-Scale Community Initiative on Early Childhood

Monitoring Medicaid outreach and expansion to families with young children

Purpose: The Early Childhood Initiative, through the Healthy Start/Medicaid Component, seeks to promote and facilitate early and continuous coverage of eligible children under age six by public health insurance. Enrollment in Medicaid is expected to result in timely and regular use of health care services by children, and therefore to promote healthy development and reduce the inappropriate use of care.

Methods: This study analyzed data on the enrollment history and utilization experience of children 5 years of age or younger, residing in Cuyahoga County. For this analysis, birth cohorts are identified in 6-month intervals, starting January 1998, and comparisons are made in the experiences of children enrolled in Medicaid from the pre-ECI period to the ECI periods.

Results: Children in later birth cohorts (post-ECI) tended to enroll in Medicaid at a younger age and remain enrolled in Medicaid for longer periods of time than those in earlier birth cohorts. The proportion of children enrolled in Medicaid as of the first month of life increased from 51.6% to 63.8%. The proportion of children receiving a first well-child visit by 1 month of age increased from 30.1% to 42.8%. Similarly, the proportion of children receiving at least 5 CPVs by their first birthday increased from 10.6% to 20.9%. However, consistent with other studies analyzing the effects of Medicaid expansion on health care utilization, no notable changes occurred in the use of Emergency Department visits.

Implications: There appear to be improving trends in measures pertaining to early and sustained enrollment in the Medicaid program, as well as early initiation and receipt of comprehensive preventive visits among infants, according to the recommended schedule of such visits. However, additional analyses are warranted to identify programmatic aspects that may have contributed to -- or hindered -- progress towards achieving program goals.

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