The Impact of the Los Angeles Healthy Kids Program on Access to Care, Use of Services, and Health Status

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Abstract

A longitudinal survey of parents of enrollees in the Los Angeles Healthy Kids Program has found that the program had significant positive impacts on children’s health and access to care.  Children experienced improvements in access to and use of ambulatory, specialty and dental care; reduced unmet need; increased parent confidence in getting care and satisfaction with quality; and reduced financial worries.  Most important, children’s health status improved, as perceived by parents and according to several measures.  Healthy Kids covers uninsured children below 300 percent of poverty who are ineligible for Medicaid or SCHIP, and primarily serves poor, undocumented Latino children.

Introduction

In July 2003 a new program called Healthy Kids began in Los Angeles County, California. The program provides health coverage for uninsured children in families with income below 300 percent of the federal poverty level who are not eligible for Medi-Cal or Healthy Families (California’s State Children’s Health Insurance Program).

This report presents results from the evaluation of the Los Angeles Healthy Kids Program showing the impact of the program on newly enrolling children one to five years of age. We found substantial positive impacts on access to care; use of specialty and dental care services; unmet need for ambulatory, preventive, specialty and dental services; and parent confidence in getting care, satisfaction with quality of care, and reduced financial worries. For example:

• The percent of children with a usual source of medical care increased by 14.7 percentage points.
  
• The percent with a usual source of dental care increased by 27.5 percentage points.
  
• The percent with an ambulatory care visit increased by 7.4 percentage points.
• The percent of children that received specialist care increased by 5.7 percentage points.
  
• The percent with dental care increased by 14.4 percentage points.
• Unmet need for specialty care decreased by 6.5 percentage points.
  
• Unmet need for dental care decreased by 9.0 percentage points.
• The percent of parents reporting that they were confident they could get care for their child increased by 21.5 percentage points.
  
• The percent of parents satisfied with their child’s health care quality increased by 16.0 percentage points..
  

The strong health care safety net for children in Los Angeles provided substantial protection for uninsured children prior to the advent of Healthy Kids, and many already had a usual source of care and preventive care before they enrolled in the program. However, there is strong evidence that their care improved after they enrolled, especially among those who had no usual source of care before enrolling. These improvements in access and use of services led to a 4.7 percentage point reduction in emergency room use after enrollment in Healthy Kids. 

Most important, the health of these young children improved in the year after they enrolled in the program, as perceived by their parents, according to several measures. This suggests that Healthy Kids has improved the prospects of success for these young children as they approach school age.

(End of excerpt. The entire report is available in PDF format.)

The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

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