Coverage is Not Enough: Lessons from the Covering Kids and Families Access Initiative

The Covering Kids and Families Access Initiative (CKF-AI) is a $4 million, 2-year grant program designed to improve access to health care for children and families enrolled in Medicaid and SCHIP. Eighteen local CKF projects received CKF-AI grants.

With funding from the Robert Wood Johnson Foundation, we conducted case studies of five CKF-AI grantees and analyzed their efforts to improve access for covered families.

We found that CKF-AI grantees engaged in systematic processes to identify and prioritize access challenges in their communities, then selected one or more to directly address. Access improvement strategies were diverse, ranging from a community health worker program in Minnesota, to prescription drug coverage improvements in Connecticut, to case management for high-users of ER services in Washington State, to translation services for non-English speakers in North Carolina, to cultural competence provider training in Maryland. To varying degrees, all programs succeeded in improving access, though data to document improvements were largely unavailable.

Grants targeted to improving access to care can be an effective mechanism for addressing community-level challenges. Future efforts would benefit from a longer implementation period and increased emphasis on data collection.

Providing health insurance for children and families is critical, but so is addressing the myriad barriers to care that may confront families once they've obtained coverage. The CKF Access Initiative reinforced that access-improvement strategies can be critical complements to outreach and enrollment efforts, and further improve families' access to needed care.