Ensuring Health Care Access through Parent Mentors

By Glenn Flores, MD, FAAP

More than 4.8 million American children lack health insurance, which is six percent of our population.

Medicaid and the Children’s Health Insurance Program have made great strides in getting more children enrolled in public health insurance programs. However, with 72 percent of those uninsured children eligible for such programs, much more needs to be done.

Parent mentors provide a valuable and proven solution towards closing that gap.

I am honored that the recent federal reauthorization of CHIP provides grant funding for organizations that use parent mentors, based on an intervention I developed with colleagues.

CHIP covers families that earn too much to qualify for Medicaid but are unable to afford private health insurance. Under the reauthorization bill, organizations that employ parent mentors are eligible to receive grants from the $120 million appropriated over six years for outreach efforts to enroll more uninsured children in public health insurance programs; address social determinants of health such as housing conditions, access to transportation, and early childhood development; and help families secure primary care, dental care and pharmacies.

The intervention included in CHIP is based on the Kids’ HELP Parent Mentors intervention I developed and researched with colleagues that was published in the journal Pediatrics in 2016.

Our research found parent mentors are significantly more effective than traditional federal outreach and enrollment methods when it comes to enrolling uninsured children in CHIP; that parent mentors help families obtain and renew insurance coverage faster; they improve access to primary care, dental care, and specialty care; they reduce unmet needs and out-of-pocket costs; they achieve higher parent satisfaction ratings; and they help families sustain long term healthcare coverage.

Specifically, our research involved 237 participants split between parent mentor and control groups. Our research determined that parent mentors successfully insured 95 percent of children they worked with, compared to only 68 percent in a control group. The mentors secured coverage twice as fast and families rated the quality of their well-child visits higher than the control group. In addition, the parent mentor group was less likely to have no primary care provider, problems getting specialty care, dissatisfaction with doctors, or unmet preventive or dental care needs.

Two years after this study, 100 percent of the children from the parent mentor group remained insured compared to 76 percent of the control group.

Our research also determined parent mentors cost an average of $53 per month per child, which represents a savings of $6,045 for every insured child per year. Based on these cost savings, estimates indicate that national implementation of parent mentor interventions to insure all Medicaid- and CHIP-eligible uninsured children could save taxpayers $17 to $20 billion every year.

With the potential cost savings so high and potential health benefits to children so great, our country can’t afford not to include parent mentoring programs in future public policy initiatives. I am thrilled to see federal lawmakers embrace our intervention in the CHIP reauthorization. I hope to see it implemented in all 50 states in the future. Our findings suggest parent mentors, and even adult peer mentors, would likely prove to be highly cost-effective interventions to reduce and even eliminate health insurance disparities, paving the way for all Americans to access health insurance and health care, while creating jobs and potentially saving our nation billions of dollars.

Glenn Flores, MD, FAAP is the chief research officer and the director of the Health Services Research Institute for Connecticut Children’s Medical Center. Dr. Flores is also associate chair of research and visiting professor of pediatrics at UConn School of Medicine.

Learn how Dr. Flores’ KIDS Help program has worked wonders at getting children covered in the March issue of Health Affairs

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