A program that provides health care coverage to uninsured children saved Los Angeles County health facilities more than $37 million in uncompensated costs over the past three years, according to an analysis led by USC community health expert Michael Cousineau.
More than 40,000 children in Los Angeles County — many of whom are ineligible for the State Children’s Health Insurance Program or Medicaid due to family income or immigration status — have been enrolled since the program launched in 2003. The Healthy Kids program currently operates in nearly 30 California counties and has linked more than 85,000 children statewide with health insurance coverage.
The findings appear in the July issue of the Journal of Public Health Management and Practice. Using data provided by Los Angeles County, the authors analyzed how the Healthy Kids program has affected use of ambulatory care services in safety net hospitals and health centers over a three-year period.
“This is the first analysis to really show that the program has made a significant impact in reducing uncompensated costs,” said Cousineau, associate professor of preventive medicine at the Keck School of Medicine of USC. “It demonstrates the practical, financial value of the program in providing coverage for children who otherwise would not have access to health insurance.”
While the role of the health care safety net in providing services for uninsured and underinsured patients has been debated in various proposals for health care reform in the United States, little is known about how health coverage expansion affects the use of these services, he noted.
Cousineau and his colleague, Albert J. Farias, project manager for the Center for Community Health Studies at the Keck School of Medicine, tracked visits to L.A. County emergency rooms and clinics during the past three years. They found that expansion of the Healthy Kids program resulted in a decrease in the use of county-funded programs for the uninsured.
The data suggests that the insurance coverage provided by Healthy Kids improves access and also reconfigures where children get their care, he said.
“Those with both public and private coverage are more likely than uninsured children to receive needed primary health care visits, have a medical home and have improved health care status,” the authors wrote in the report.
The Healthy Kids coalition is currently financed through a combination of private and state funds. Cousineau said a more effective, long-term solution would be to fold all the individual county programs into a statewide program that covers all children in California.
“The success of Healthy Kids demonstrates the value of universal coverage,” he said. “It will help to stabilize the county safety net and will help alleviate the tremendous financial shortfall that Los Angeles County hospitals are facing.”