Does SBHC Use Translate into Cost Savings for Medicaid? An Empirical Study

The Health foundation of Greater Cincinnati has funded fifteen SBHCs in the greater Cincinnati area in order to increase health care accessibility for students in these communities. Previous health care cost evaluation was limited because we were unable to identify whether or not students used SBHCs during the study period. The objective of this study is to evaluate the effects of the SBHC program on overall health utilization and costs for students who used the SBHCs compared to students who didn't use the SBHCs and to students in comparable school districts without SBHCs. Combined datasets from the SBHC encounter data and Medicaid medical claims database are used for this study. The SBHC encounter data recorded clinical encounters about how students used the SBHC programs from 2000 to 2003. The Ohio Medicaid medical claims data contain all medical and pharmacy records for SBHC students 3 years prior and 3 years post SBHC implementation. Analysis of covariance is used to compare the health care utilization and costs among SBHC users, students in SBHC schools, and students in non-SBHC comparison groups based on the combined datasets, including hospitalization, emergency room visits, mental health services, physician encounters, prescription drugs, and other health services. Moreover, we examine two student subgroups with chronic illnesses, asthma and ADHD.