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Enrollment in Healthy Kids is associated with some improvement in eliciting parent concerns and providing health education, but participation did not increase information for parents about their concerns or affect the proportion of children for whom parents have some type of concern regarding learning, development or behavior. The lack of improvement in these areas despite enrollment in a medical insurance program likely results from larger systems-level barriers to adequate developmental assessment/monitoring and anticipatory guidance within primary care. Findings suggest these barriers such as time, competing demands, and incentives in primary care are not reduced simply by enrollment in health insurance. Los Angeles: University of California at Los Angeles. September 2009.