Using a voucher system to extend health services to migrant farmworkers

Area of Science:

• Public Health
• Health Services Research
• Rural Health

Background:

• La Clinica de los Campesinos, Inc. is a federally funded migrant health clinic established in 1973.
• A voucher program was implemented in 1988 to extend healthcare access.
• Charges for outpatient care are determined by the patient's ability to pay.

Purpose of the Study:

• To evaluate the effectiveness of La Clinica's voucher program.
• To assess the utilization and financial impact of the voucher system.
• To explore the model's potential for coordinating services in underserved areas.

Main Methods:

• Analysis of 1,794 vouchers submitted between April 1, 1992, and March 30, 1993.
• Tracking of partial health care payments made by La Clinica.
• Examination of reimbursement values and covered service types.

Main Results:

• 677 participants utilized the voucher program, totaling $83,833 in partial payments.
• Median payment per voucher was $22, with a range from $1 to $979.
• Voucher payments covered a median of 60% of bills, varying by provider type (dentists 70%, clinics 42%).

Conclusions:

• The voucher program successfully facilitated access to services not available at La Clinica.
• This model demonstrates a viable strategy for healthcare providers serving dispersed populations.
• The concept warrants further investigation amid national healthcare reform discussions.