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 Roughly four million uninsured kids are eligible for free or
low-cost coverage through two U.S. health programs: Medicaid for the
poor and the Children’s Health Insurance Program (CHIP). Often,
they’re uninsured because parents don’t know they qualify for help
or how to apply.
When researchers randomly paired some parents with peer mentors to
help with applications, however, far more kids got covered than when
parents were left to grapple with enrollment on their own. Once they
got benefits, the parents with peer mentors also had fewer problems
getting care for their kids.
“The parent mentor intervention is interactive, provides social
support, connects parents of uninsured children with other parents
who successfully insured their own children and come from the same
neighborhoods and similar racial/ethnic backgrounds, and includes
parent mentor training on providing assistance with pediatric care,”
said lead study author Glenn Flores, a health policy specialist at
Medica Research Institute in Minneapolis, Minnesota.
Absent this help, parents got information on Medicaid and CHIP from
advertising on radio, television, the Internet and public transit as
well as outreach at community centers and daycare facilities.
“It appears that traditional Medicaid/CHIP outreach and enrollment
are less effective because they employ largely passive mechanisms,”
Flores added by email.
In a small experiment pitting peer mentors against traditional
outreach methods, Flores and colleagues followed 237 parents for one
year to see how many got their children enrolled in Medicaid or
CHIP. Roughly half of the parents got mentors.
By the end of the study, 95 percent of mentored parents got coverage
for their kids, compared with 68 percent of the parents who didn’t
receive this assistance, researchers report in the journal
Pediatrics.
Half of the parents with mentors got their kids coverage within
about two months, compared with more than four months without
mentoring.
Just 15 percent of children in mentored households lacked primary
care providers, compared with 39 percent of the other kids.
For specialist care, just 11 percent of kids in the mentor group had
trouble seeing doctors, compared with 46 percent of the other
children.
Parents also reported more satisfaction with coverage and were more
likely to renew benefits when they had mentors to guide them along
the way.
Two years after mentoring stopped, all of the kids enrolled with
this help were still insured, compared with 76 percent of children
whose parents navigated the system on their own.
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For each child covered, mentors cost about $53 a month. But
researchers calculated that mentors saved roughly $6,045 a year in
avoided costs from hospitalizations, intensive care, emergency
department visits and lost wages for parents who missed work to tend
to their kids.
The experiment was conducted in urban populations of Hispanic and
black people in Texas, and the findings might not be the same
elsewhere, the authors note. It’s also possible that the contact
researchers had with parents not receiving mentors inflated
enrollment in this group which otherwise might have been even less
likely to get benefits outside of the study.
Another limitation of the study is its reliance on parents to report
what care children received. Because this wasn’t verified by medical
records, it’s possible faulty recollections could have influenced
the results.
Still, the results suggest mentors may be one way insure more kids,
said Dr. Joshua Sharfstein, a researcher at the Johns Hopkins
Bloomberg School of Public Health in Baltimore who wasn’t involved
in the study.
“Signing up for insurance requires trust, and this paper shows that
parent mentors can connect to others to help them understand the
value of insurance and enroll,” Sharfstein said by email.
Mentors also worked because they were just a call or text away
anytime questions cropped up, noted Dr. Michael Weitzman, a
pediatrics researcher at New York University School of Medicine who
wasn’t involved in the study.
“It’s like having a friend who’s just really good at insurance stuff
and wants to help,” Weitzman said by email.
SOURCE: http://bit.ly/22nBhII Pediatrics, online March 17, 2016.
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