The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64313

Carolyn A Berry, PhD¹, Barbara Langner, PhD², Linda Chen, MPH, MPA¹, and Peter Budetti, MD, JD³. (1) Wagner Graduate School of Public Service, New York University, 726 Broadway, 5th Floor, New York City, NY 10003, 212-998-7465, cb79@nyu.edu, (2) University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, (3) Institute for Health Services Research and Policy Studies, Feinberg School of Medicine of Northwestern University, 339 E. Chicago Avenue, 7th Floor, Chicago, IL 60611

Background: Low-income children are vulnerable to developmental threats and lack of access to resources and services. Almost from the inception of the Medicaid program there have been concerted efforts to integrate such services for low-income children into the Medicaid benefit package, although implementation has fallen short of the goal. With funding from the Commonwealth Fund under its ABCD (Assuring Better Child Health and Development) initiative, four state Medicaid agencies have partnered with other key players in their states to incorporate the delivery of preventive services into Medicaid. Methods: Process evaluation over three years using primarily qualitative methods including site visits, key informant interviews, document review, and participant observation of meetings/conference calls of the four-state consortium. Results: States were able to implement system changes that facilitated the delivery of preventive services to Medicaid child enrollees. The states adopted various approaches depending upon characteristics of their environment, agency culture, and past decisions. Important pre-conditions for success included history of partnering with the state’s department of health/public health, adequate access to primary care providers, and a collaborative orientation among key state and private agencies. Conclusions: The Medicaid program has a dual mission to deliver both preventive and acute care services to enrollees. Primary emphasis has been on the delivery of acute care services and preventive services have often been underrepresented. The lessons learned thorough these preventive care enhancement projects provide information about approaches that have been successful in expanding access of Medicaid child enrollees to preventive care.

Learning Objectives:

• Articulate ways Medicaid can enhance preventive services for children.
• Understand the role and importance of collaboration between Medicaid and Public Health in promoting low-income children's health.
• Identify important pre-conditions for successful prevention-oriented initiatives.

Presenting author's disclosure statement:
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.