John D. Cowden, MD, MPH reviewing Flores G et al. Pediatrics 2016 Apr.

Trained parent mentors improved health insurance coverage and access to care for low-income minority children.

Almost 6 million U.S. children are uninsured, even though most are eligible for coverage through Medicaid or the Children's Health Insurance Program (CHIP). Minority children are at special risk for lacking insurance, but the best way to get and keep them enrolled has not been determined.

To test whether the use of parent mentors would improve the rate of health insurance coverage for minority children, investigators conducted a randomized controlled trial (Kids' HELP) in which 237 evaluable low-income, uninsured minority children and their parents were randomized to receive health insurance support from a specially trained parent mentor or through a traditional state-sponsored Medicaid outreach program (controls). Parent mentors, who had at least one child of their own with Medicaid or CHIP coverage, were recruited from the same communities as the study subjects. After attending a 2-day training course, mentors supported their assigned intervention subjects for 12 months with insurance applications and access to healthcare.

After 1 year of support, parent-mentored children were more likely than controls to have insurance (the primary outcome; 95% vs. 68%) and a primary care provider (85% vs. 61%) in addition to having lower out-of-pocket medical costs. Mentored children also had fewer unmet healthcare needs and higher parent satisfaction with care. The mean cost of mentor support was $53 per child per month, and healthcare cost savings for each insured child was $6045 per year.

Citation(s):

Flores G et al. Parent mentors and insuring uninsured children: A randomized controlled trial. Pediatrics 2016 Apr; 137:e20153519.

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