THE USE OF EPSDT AND OTHER HEALTH-CARE SERVICES BY CHILDREN ENROLLED IN MEDICAID - THE IMPACT OF OBRA89

To increase the participation of Medicaid children in the Early and Pe riodic Screening, Diagnosis and Treatment (EPSDT) program and to impro ve their health, Congress included several provisions in the Omnibus B udget Reconciliation Act of 1989 (OBRA'89) that addressed problematic program features. The impact of these provisions on children's health service use was investigated in a study funded by the Health Care Fina ncing Administration. After conducting site visits to four states, the authors analyzed claims data for the children residing there and foun d evidence that, in 1992, these states placed a higher priority on imp roving the effectiveness of EPSDT than they did before 1989. The state s' efforts to expand the EPSDT provider base and to enhance outreach a nd service provision were either directly or indirectly inspired by OB RA'89. The authors also found evidence of a significant impact on prov ider participation and caseloads and on children's use of both prevent ive care and diagnostic and treatment services. However, the effects w ere modest in comparison to the size of the progress chat is required.