Nearly one-third of children enrolled in the federal Children's Health Insurance Program (CHIP) receive no or very little care, while 72% of the program's spending is concentrated on 10% of children with chronic conditions.
This finding in yesterday's journal Health Affairs suggests that children who get no care may appear healthier than other enrollees, but "they are getting little preventive care, such as well-child visits and dental checkups.
"With so little contact with providers, these children are at increased risk of having health problems that go undiagnosed and untreated," they wrote.
Additionally, children in the zero spending group are disproportionately poor and African American.
The paper focuses on growing discussion in health reform about ways to "bend the curve" of cost growth in public programs, such as increasing cost sharing levels or introducing more high-deductible plans, reducing benefit or eligibility levels or adopting disease management programs.