205549 Dental care utilization under the Los Angeles Healthy Kids Program: Successes and challenges

Tuesday, November 10, 2009

Sara Hogan, MHS , Health Policy Center, The Urban Institute, Washington, DC
Ian T. Hill, MPA, MSW , Health Policy Center, The Urban Institute, Washington, DC
Embry M. Howell, MSPH, PhD , Health Policy Center, The Urban Institute, Washington, DC
The Los Angeles Healthy Kids Program was launched in 2003 to extend comprehensive health insurance to children in families with incomes below 300 percent of poverty who are ineligible for Medi-Cal and Healthy Families. This study draws upon results from multiple qualitative and quantitative components of a five-year evaluation of the program, begun in 2004, and presents new results from analysis of encounter data from the program's dental plan. Findings indicate that coverage and delivery of general and specialty dental services through Healthy Kids has not gone entirely smoothly. Case studies found that children were often assigned to different dentists than their parents had selected, leading to confusion and delays in obtaining care. In focus groups, most parents reported their children received high quality dental care, yet also spoke of long waits for appointments. Many parents complained that they were inappropriately charged for dental services, sometimes as much as $100 for fillings. Household survey results reveal that Healthy Kids enrollment is associated with improved access to a usual source of dental care, yet recent analysis of dental plan encounter data indicates that only 40 percent of enrollees received care in 2007, the lowest rate among all California Healthy Kids programs. Thus, while the Healthy Kids Evaluation has demonstrated that the program greatly improved coverage and access to health services for nearly 40,000 poor, undocumented, Latino children, it also finds that, like many public insurance programs, Healthy Kids has been confronted numerous challenges in meeting the dental care needs of children.

Learning Objectives:
Describe the design and implementation of the Los Angeles Healthy Kids program; Understand the mixed methods used by the evaluation, including the process of analyzing of dental claims data; and Identify the various challenges that Healthy Kids has faced in attempting to provide high quality dental care to children enrolled in the program.

Keywords: Child Health, Oral Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Our research team, led by Ian Hill and Embry Howell - who each respectively have over 20 years of maternal and child health policy research experience - currently heads the ongoing, 5-year evaluation of the Los Angeles County Healthy Kids Program, which consists of multiple qualitative and quantitative components and examines issues related to Healthy Kids access and utilization over time.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.