Address correspondence to Genevieve M. Kenney, Ph.D., is with the Urban Institute, 2100 M St. NW, Washington, DC 20037; e-mail: firstname.lastname@example.org. James Marton, Ph.D., is with the Georgia State University, Atlanta, GA 30302. Ariel E. Klein, B.A., is with the Division of Health Care Finance and Policy, Commonwealth of Massachusetts, Boston, MA. Jennifer E. Pelletier, B.A., is with the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN. Jeffery Talbert, Ph.D., is with the University of Kentucky, Lexington, KY.
The Effects of Medicaid and CHIP Policy Changes on Receipt of Preventive Care among Children
Article first published online: 5 NOV 2010
© Health Research and Educational Trust
Health Services Research
Volume 46, Issue 1p2, pages 298–318, February 2011
How to Cite
Kenney, G. M., Marton, J., Klein, A. E., Pelletier, J. E. and Talbert, J. (2011), The Effects of Medicaid and CHIP Policy Changes on Receipt of Preventive Care among Children. Health Services Research, 46: 298–318. doi: 10.1111/j.1475-6773.2010.01199.x
- Issue published online: 3 JAN 2011
- Article first published online: 5 NOV 2010
- Medicaid and CHIP reimbursement;
- preventive care;
- managed care;
Objective. To examine changes in children's receipt of well-child and preventive dental care in Medicaid/Children's Health Insurance Program (CHIP) in two states that adopted policies aimed at promoting greater preventive care receipt.
Data Sources. The 2004–2008 Medicaid/CHIP claims and enrollment data from Idaho and Kentucky.
Study Design. Logistic and hazard pre–post regression models, controlling for age, gender, race/ethnicity, and eligibility category.
Data Extraction Methods. Claims and enrollment data were de-identified and merged.
Principal Findings. Increased reimbursement had a small, positive association with well-child care in Idaho, but no consistent effects were found in Kentucky. A premium forgiveness program in Idaho was associated with a substantial increase (between 20 and 113 percent) in receipt of any well-child care and quicker receipt of well-child care following enrollment. In Kentucky, children saw modest increases in receipt of preventive dental care and received such care more quickly following increased dental reimbursement, while the move to managed care in Idaho was associated with a small increase in receipt of preventive dental care.
Conclusions. Policy changes such as reimbursement increases, incentives, and delivery system changes can lead to increases in preventive care use among children in Medicaid and CHIP, but reported preventive care receipt still falls short of recommended levels.