311611
Evaluation of health insurance application and enrollment assistance services in securing a medical home or usual source of care among Children's Health Outreach Initiatives (CHOI) clients in Los Angeles County: A longitudinal cohort analysis
Methods: Analyses are based on a cohort of applicants (N=23,423) that received application/enrollment assistance through CHOI services from Jan 1, 2011 through Dec 31, 2011. Usual source of care status was determined for clients at time of enrollment (intake) and nine months post-enrollment (utilization follow-up). Type of medical home was identified for clients stating having a usual source of care at intake and follow-up. Effectiveness of the application and enrollment process was measured through: 1. percent change in status of usual source of care from intake to utilization, and 2. percent change in type of medical home or place of care from intake to utilization. Distribution of clients, by service planning area (SPA), without a medical home (N=5,907) at intake, was also determined to consider geographic disparities within the County.
Results: Seventy-four percent of clients in the cohort had a source of care at time of intake and 26% did not. At utilization follow-up, 96% of clients had a medical home and 4% did not. Of those clients with medical home at intake, majority (74%) indicated doctor’s office as place of care and 24% indicated community clinic. At utilization follow-up, 85% indicated doctor’s office as place of care and 14% indicated community clinic. Of those clients with no medical home at intake, majority (25%) resided in San Gabriel Valley SPA. Antelope Valley SPA had the highest proportion of clients with no medical home compared to those with a medical home at intake (97% vs 3%).
Conclusion: Application assistance/enrollment assistance services prove effective in reducing the proportion of clients without a medical home from 26% to 4% from intake to utilization follow-up. After assistance, there is an 11 percentage point increase in doctor’s office as type of medical home and a 10 percentage point decrease in community clinics being the medical home. Among clients with no medical home at intake, disparities exist by service planning area.
Learning Areas:
Conduct evaluation related to programs, research, and other areas of practiceProvision of health care to the public
Public health or related research
Learning Objectives:
Analyze changes in source of care and medical home status among clients receiving application assistance in Los Angeles County
Assess the effectiveness of health insurance enrollment and application assistance process in securing a medical home
Identify regional disparities among clients with and without a medical home at time of application enrollment in Los Angeles County
Qualified on the content I am responsible for because: As a Research Analyst III with Maternal, Child, and Adolescent Health Programs within Los Angeles County Department of Public Health, Suvas Patel performs data management, analysis, and evaluation activities for the Children's Health Outreach Iniatives. Suvas is experienced in applied epidemiologic methods and program evaluation and holds an Masters in Public Health with focus in Epidemiology/Biostatistics.
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.