Kansas Demonstration to Maintain Independence and Employment (DMIE)

The Kansas Demonstration to Maintain Independence and Employment (DMIE) provided state Medicaid and other health and employment support services as wraparound coverage to 200 people with health insurance through the Kansas high-risk pool, also known as the Kansas Health Insurance Association (KHIA). People in the high-risk pool experience multiple severe conditions for which they have been unable to obtain employer-sponsored coverage or reasonably priced private coverage. They are ineligible for either Medicaid or Medicare and about one-third of participants are employed. The goals of the project was to improve the health and quality of life of individuals in the intervention group and demonstrate that, compared to a carefully matched control group of 200 individuals also in the pool, they maintain a higher rate of employment and are less likely to become eligible for any form of Social Security disability benefits or other forms of public assistance. 

University of Kansas staff provided independent, external evaluation of the project. Measures used for project evaluation included self-reported demographic and health status, administrative data about health care use and expenditures from KHIA and the Kansas Medicaid agency, earnings data from the Kansas Unemployment Insurance Division, and other data collected through assessments, questionnaires, surveys, interviews and focus groups. Specific research questions to be answered were: 

  1. How does self-reported health status and quality of life change over time for participants in the intervention and control groups? 

  1. How does access to care and service use for the two groups change over time? 

  1. How do medical costs for the two groups change over time? 

  1. How does employment change over time for the two groups? More specifically, how do absenteeism, earnings, and self-reported levels of job performance change over time in addition to rates of employment and unemployment? 

  1. Which employment support services are most frequently utilized and what is their perceived impact by participants? 


Contact Jean Hall, Ph.D., Principal Investigator 




DMIE Newsletter January 2008 (PDF available upon request) 

DMIE Newsletter October 2007 (PDF available upon request) 

DMIE Newsletter July 2007 (PDF available upon request) 

DMIE Newsletter April 2007 (PDF available upon request) 

DMIE Newsletter Jan 2007 (PDF available upon request) 

DMIE Newsletter Oct 2006 (PDF available upon request) 

Research Findings 

Kansas DMIE White Paper January 2006 (PDF available upon request)

Kansas DMIE Final Report (DOC)

Hall, J.P., Carroll, S.L., & Moore, J.M. (2010) Health care behaviors and decision-making processes among enrollees in a state high-risk insurance pool: Focus group findings. American Journal of Health Promotion, 24(5), 304-310. 


Hall, J.P., & Moore, J.M. (2008). Does high risk pool coverage meet the needs of a population at risk for disability? Inquiry, 45(3), 340-352.