Unlike Medicaid, the hawk-i program has children and youth as its only enrollee group. The health and utilization outcomes for this group are extremely important in assessing the quality of care provided. Most particularly, these data allow us to determine whether children and youth have equal access to services across plans. The rates that include children and youth eligible for 11 and 12 months provide the best information as to the effectiveness of the health plans in providing the appropriate services to children. While 100 percent utilization is the desired goal, factors outside the control of the health plans also affect whether a child receives a service at the appropriate time, making this goal unlikely.

From an overall perspective, children and youth in hawk-i are not utilizing preventive services at rates consistent with established AAP or AAPD guidelines. Of greatest concern are the rates of receipt of preventive medical visits--which are lower than those found for Medicaid managed care plans--and of preventive dental visits, especially for children in Iowa Health Solutions. The low MMR immunization rates are also of concern, but without the ability to determine if a child received an immunization at a public health clinic, it is difficult to determine if a problem exists.