| Sumario: | Part of a special section on mental health services and vulnerable populations. The writers explore whether a health maintenance organization's (HMO's) capacity and incentives to manage care might be exploited to improve access. In the early 1990s, the Florida Healthy Kids demonstration extended Medicaid-like HMO coverage to poor children in the public schools of Volusia County, Florida. Uninsured student months in area public schools were probably reduced by one half. In addition, measures of access, utilization, and satisfaction for enrollees were similar to, and sometimes superior to, non-enrollees possessing private insurance, and utilization and cost levels for the enrollees were indistinguishable from commercial clients. These results indicate the value of using schools as a medium for providing coverage and highlight the importance of taking steps to manage access to reduce nonfinancial barriers to care.
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