Kids Medi-Cal Program Cuts Costs

A program that concurrently provides curative and palliative care to children enrolled in Medi-Cal has significantly cut spending per child, according to new data from the UCLA Center for Health Policy Research.

Launched in 2009 in 11 of California’s 58 counties, the pilot program provides palliative care to pediatric Medi-Cal enrollees with life-endangering conditions no matter whether their condition is terminal. 

Under current Medi-Cal regulations, palliative care is only rendered in the last six months of a child’s life.

According to the data from the three-year pilot project, known as Partners For Children, the combination of palliative and curative care cut costs an average of $1,677 per child per month, or more than $20,000 per year. That represents an 11% overall savings on costs for treating pediatric Medi-Cal enrollees with life-threatening illnesses.

Overall, there are about 500,000 children in the United States enrolled in Medicaid who are fighting life-threatening illnesses. A total of 123 children were enrolled in the Parent For Children program in California as of last spring. Nearly 70% of the children are Latino males. 

Prior to their enrollment in the PFC program, 65% of their healthcare costs were associated with inpatient hospital care, and 26% was pegged to outpatient care. Total healthcare costs averaged $15,653 per month.

Once enrolled in PFC, children receive more extensive pain and symptom management, along with art and music therapy. 

Parents received training on how to use any home healthcare equipment they need. They were also given access to an around-the-clock urgent care hotline, occasional breaks in caring for the child, and bereavement counseling if the child died.

After enrollment in the program, costs for hospitalization were reduced to 47% of the total, while less costly outpatient care grew to 39% of the total. 

As a result, total healthcare costs dropped to $13,976 per month.

Moreover, families also reported decreased levels of anxiety, greater confidence in being able to care for their child, and higher levels of sleep.

UCLA researchers recommended that the program be expanded beyond the 11 counties in which it currently operates, pending full analysis of the pilot project data. 

It also encouraged greater hospice participation.