5138.0: Wednesday, November 15, 2000 - 12:45 PM

Abstract #823

Examining Enrollment Pathways of Children in Publicly Funded Health Insurance Programs: Lessons From a State Initiative

E. Feinberg, RN M.Sc, Department of Maternal and Child Health, Harvard School of Public Health and Massachusetts Department of Public Health, 250 Washington Street - 5th Floor, Boston, MA 02108, 617-624-6039, feinberg@hsph.harvard.edu, J. Gardner, DSc, Department of Maternal and Child Health, Harvard School of Public Health, D. Klein Walker, EdD, Massachusetts Department of Public Health, K. Swartz, PhD, Department of Health Policy and Management, Harvard School of Public Health, and A. Zaslavsky, PhD, Department of Health Care Policy, Harvard Medical School.

Understanding enrollment pathways of children in publicly funded health insurance programs is critical to expanding the participation of children who are eligible for Medicaid and state Child Health Insurance Programs (CHIP). We surveyed 1055 parents of children who were Medicaid-eligible based on reported family income. Children were enrolled in a state-sponsored health insurance program, instead of the traditional Medicaid program. We investigated methods of enrollment, whether families had assistance with enrollment, and sources of assistance. Multivariate and multinomial logistic regression was used to model relationships between enrollment variables and family characteristics. Initial access to the program was by telephone for 40% of respondents. A similar percentage received assistance completing the application form. Among families who received assistance with enrollment, 40% had help from staff at the telephone information line. We found that other-language speakers and English-only speakers utilized different enrollment paths. As compared to English-only speakers, other-language speakers were significantly less likely to use the telephone to enroll and significantly more likely to have received assistance to complete the application form. We analyzed associations between language and sources of assistance, whether from a medical site, from a friend or family member, or from staff at the telephone information line. As compared to English-only families, other-language speakers were more likely to rely upon medical sites and family and friends for enrollment assistance than the telephone line. Need for assistance with enrollment is common among English and other-language speakers but the source of this assistance differs by language group.

Learning Objectives: At the conclusion of this session , the participant will be able to: 1.Identify the characteristics of families most likely to need assistance enrolling children in publicly funded health insurance programs 2. Discuss the relationship between family characteristics and source of enrollment assistance 3.Develop analytic framework to create a community-based strategy to assist families to enroll eligible children in publicly funded health insurance

Keywords: Access to Health Care, Health Insurance

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA