Medicaid Managed Care:

Healthy Moms, Healthy Kids--A New Program for Chicago

HRD-93-121: Published: Sep 7, 1993. Publicly Released: Sep 7, 1993.

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Pursuant to a congressional request, GAO provided information on management control and oversight problems in the Healthy Moms, Healthy Kids program, focusing on: (1) whether the program has adequate controls to prevent the recurrences of such problems; and (2) challenges to successful implementation of the program.

GAO found that: (1) the Healthy Moms, Healthy Kids program includes oversight and quality control initiatives that could address oversight and management control weaknesses including removing the financial incentives to underserved patients, addressing quality assurance issues, requiring the collection of patient and provider utilization data, and conducting patient surveys; (2) there is not sufficient program data to adequately assess the effectiveness of these initiatives; (3) the Illinois Department of Public Aid (IDPA) needs to address funding limitations and health care staff retention problems before a successful Healthy Moms, Healthy Kids program can be implemented; (4) to attract and retain sufficient numbers of health care providers, IDPA has offered health care providers increased payment rates, patient selection options, access to health care specialists, and better patient treatment compliance through case management; and (5) local community organizations question whether IDPA has sufficient resources to implement the program and maintain the quality of care delivered.

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