Early Intervention

Early intervention programs for children and their families can help prevent costly problems, such as low birth weights or deaths from vaccine-preventable diseases, and reduce the need for later, publicly financed care. Unless the value of such care is quantified, however, legislators have a hard time factoring its value into their budgetary decisions. Using a framework it developed to analyze the costs and benefits of early intervention, GAO concludes that providing pregnant women with benefits under the Special Supplemental Food Program for Women, Infants, and Children (WIC) more than pays for itself within a year. GAO estimates that over an 18-year period, WIC benefits could help avoid more than $1 billion in federal, state, local, and private payer expenditures. On a related matter, GAO discovered that the formula used to distribute WIC funds to the states does not adequately consider the number of eligible persons in the states. As a result, some states cannot enroll all pregnant women, while others enroll infants and children considered less in need of services.

GAO used a framework that it developed to assess the costs and benefits of early intervention programs and found that: (1) providing WIC benefits to pregnant women pays for itself within a year; (2) prenatal WIC benefits have reduced the rate of low birthweight births by 25 percent and very low birthweight by 44 percent; (3) 1990 prenatal WIC benefits cost the federal government $296 million, but avoided over $472 million in expected first-year federal and state Medicaid expenditures; (4) over an 18-year period, an estimated $1 billion in federal, state, local, and private-payer expenditures could be averted as a result of WIC; (5) because of high initial medical costs, over three-fourths of the estimated savings due to WIC resulted from avoiding medical costs in the first year; (6) the formula used to distribute WIC funds to the states does not adequately consider the number of eligible persons in states and, as a result, some states cannot enroll all eligible pregnant women, while other states can only enroll lower priority applicants; (7) WIC only served an estimated 75 percent of all income-eligible pregnant women who would have given birth in 1990; and (8) providing WIC benefits to all income-eligible pregnant women who would have given birth in 1990 would have cost $407 million, or $111 million more than was spent, but would have returned more than $1.3 billion in avoided expenditures over the next 18 years.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Team: Phone: