The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67293

Michael Cousineau, DrPH and Alysia Y. Kwon, MS. School of Family Medicine, Division of Community Health, University of Southern California, Keck School of Medicine, 3375 S. Hoover St., Ste. H201, Los Angeles, CA 90007, 213-821-0700, cousinea@usc.edu

This paper presents results of an environmental scan of outreach, enrollment, retention and utilization across 7 California counties that assessed effects of state budget cuts, postponements of legislative efforts to expand coverage and streamline enrollment and local strategies counties used to increase participation in public health insurance programs. Key informant interviews, focus groups, brief interviews and financial analyses in Los Angeles, San Diego, Santa Cruz, Orange, Alameda and Fresno Counties were employed to gain insight into what’s being done to help people get enrolled and establish a medical home.

Interventions aimed to increase enrollment in publicly subsidized health insurance programs will only succeed in protecting the safety net of providers if adequate funds and resources are dedicated to improving retention and utilization of services. Because funding mechanisms prioritize enrollment numbers as outcomes, grant-funded community service-oriented organizations are forced to allocate funds to outreach and enrollment without balanced attention to helping people re-enroll, access providers and use services appropriately. By effectively keeping people enrolled in federally funded programs such as Medicaid and SCHIP, states will ensure the survival of their health care safety net in three ways: 1) by reducing uncompensated visits to health providers including county-subsidized health centers and hospitals, 2) by increasing the likelihood that low-income uninsured families will establish a regular source of care and have access to preventive services thus reducing potential need for chronic care management and 3) by improving the level of health and well-being of families who seek urgent and emergency care.

Learning Objectives:

• 1) Recognize the utility of a short-term environmental scan in making assessments amidst a rapidly changing political and economic climate.
• 2) Describe the racial/ethnic, socioeconomical and geographical factors that contribute to varying sizes of medically indigent populations throughout California.
• 3) Articulate key findings and recommendations for coordinating outreach, enrollment, retention and utilization efforts in California.
• 4) Identify three key issues of data tracking and problems encountered in centralizing data across providers.

Keywords: Access to Health Care, Safety Net Providers

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.