Glenn Flores1, Hua Lin2, Candy Walker3, Michael Lee4, Janet M Currie5, Rick Allgeyer6, Marco Fierro2, Monica Henry2, Alberto Portillo2, Kenneth Massey2. 1. Medica Research Institute, Minnetonka, Minnesota; glenn.flores@medica.com. 2. University of Texas Southwestern Medical Center, Dallas, Texas; 3. Texas Scottish Rite Hospital for Children, Dallas, Texas; 4. University of Texas Southwestern Medical Center, Dallas, Texas; Children's Health System of Texas, Dallas, Texas; 5. Center for Health and Well-Being, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, New Jersey; and. 6. Center for Strategic Decision Support, Texas Health and Human Services Commission, Austin, Texas.
Abstract
BACKGROUND: Six million US children are uninsured, despite two-thirds being eligible for Medicaid/Children's Health Insurance Program (CHIP), and minority children are at especially high risk. The most effective way to insure uninsured children, however, is unclear. METHODS: We conducted a randomized trial of the effects of parent mentors (PMs) on insuring uninsured minority children. PMs were experienced parents with ≥1 Medicaid/CHIP-covered child who received 2 days of training, then assisted families for 1 year with insurance applications, retaining coverage, medical homes, and social needs; controls received traditional Medicaid/CHIP outreach. The primary outcome was obtaining insurance 1 year post-enrollment. RESULTS:We enrolled 237 participants (114 controls; 123 in PM group). PMs were more effective (P< .05 for all comparisons) than traditional methods in insuring children (95% vs 68%), and achieving faster coverage (median = 62 vs 140 days), high parental satisfaction (84% vs 62%), and coverage renewal (85% vs 60%). PM children were less likely to have no primary care provider (15% vs 39%), problems getting specialty care (11% vs 46%), unmet preventive (4% vs 22%) or dental (18% vs 31%) care needs, dissatisfaction with doctors (6% vs 16%), and needed additional income for medical expenses (6% vs 13%). Two years post-PM cessation, more PM children were insured (100% vs 76%). PMs cost $53.05 per child per month, but saved $6045.22 per child insured per year. CONCLUSIONS: PMs are more effective than traditional Medicaid/CHIP methods in insuring uninsured minority children, improving health care access, and achieving parental satisfaction, but are inexpensive and highly cost-effective.
RCT Entities:
BACKGROUND: Six million US children are uninsured, despite two-thirds being eligible for Medicaid/Children's Health Insurance Program (CHIP), and minority children are at especially high risk. The most effective way to insure uninsured children, however, is unclear. METHODS: We conducted a randomized trial of the effects of parent mentors (PMs) on insuring uninsured minority children. PMs were experienced parents with ≥1 Medicaid/CHIP-covered child who received 2 days of training, then assisted families for 1 year with insurance applications, retaining coverage, medical homes, and social needs; controls received traditional Medicaid/CHIP outreach. The primary outcome was obtaining insurance 1 year post-enrollment. RESULTS: We enrolled 237 participants (114 controls; 123 in PM group). PMs were more effective (P< .05 for all comparisons) than traditional methods in insuring children (95% vs 68%), and achieving faster coverage (median = 62 vs 140 days), high parental satisfaction (84% vs 62%), and coverage renewal (85% vs 60%). PM children were less likely to have no primary care provider (15% vs 39%), problems getting specialty care (11% vs 46%), unmet preventive (4% vs 22%) or dental (18% vs 31%) care needs, dissatisfaction with doctors (6% vs 16%), and needed additional income for medical expenses (6% vs 13%). Two years post-PM cessation, more PM children were insured (100% vs 76%). PMs cost $53.05 per child per month, but saved $6045.22 per child insured per year. CONCLUSIONS:PMs are more effective than traditional Medicaid/CHIP methods in insuring uninsured minority children, improving health care access, and achieving parental satisfaction, but are inexpensive and highly cost-effective.
Authors: P G Szilagyi; J Zwanziger; L E Rodewald; J L Holl; D B Mukamel; S Trafton; L P Shone; A W Dick; L Jarrell; R F Raubertas Journal: Pediatrics Date: 2000-02 Impact factor: 7.124
Authors: Glenn Flores; Hua Lin; Candice Walker; Michael Lee; Janet M Currie; Rick Allgeyer; Alberto Portillo; Monica Henry; Marco Fierro; Kenneth Massey Journal: BMC Public Health Date: 2017-05-23 Impact factor: 3.295