Children's service use during the transition to PCCM in two states

Area of Science:

• Pediatric Healthcare
• Health Services Research
• Public Health Policy

Background:

• Primary Care Case Management (PCCM) programs aim to coordinate care for children.
• The implementation of PCCM programs in Alabama and Georgia coincided with changes in healthcare utilization.
• Understanding the impact of PCCM on care access is crucial for pediatric health policy.

Purpose of the Study:

• To evaluate changes in the utilization of primary, preventive, and emergency healthcare services following the implementation of PCCM programs for children in Alabama and Georgia.
• To assess whether PCCM implementation affected adherence to recommended healthcare use rates.

Main Methods:

• Analysis of longitudinal claims data for children enrolled in healthcare programs.
• Controlling for variations in the geographic availability of Medicaid providers during the study period.
• Comparing healthcare utilization rates before and after PCCM program implementation.

Main Results:

• A significant decline in the use of primary, preventive, and emergency care was observed after PCCM implementation.
• Utilization rates for primary and preventive care fell below national averages and recommended benchmarks.
• The study identified challenges faced by families in transitioning to unfamiliar PCCM providers as a key factor.

Conclusions:

• PCCM program implementation in Alabama and Georgia was associated with reduced healthcare utilization among children.
• The decline in care use, particularly for primary and preventive services, raises concerns about access and adherence to recommended guidelines.
• Family-related barriers to adopting new care management systems require attention to ensure effective healthcare delivery.