Search Results: MCHLine

Annotation: This issue brief describes Medicaid initiatives to improve maternal and birth outcomes. Included are examples of state initiatives based on bundled payments, blended payment rates, reduced payment and nonpayment, pay for performance, and medical home models. Background information on maternity care, including cesarean deliveries, early elective deliveries, and prenatal and postpartum care is also provided.

Contact: Medicaid and CHIP Payment and Access Commission, 1800 M Street, N.W., Suite 360 South, Washington, DC 20036, Telephone: (202) 350-2000 Fax: (202) 273-2452 E-mail: [email protected] Web Site: http://www.macpac.gov Available from the website.

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Keywords: Childbirth, Cost containment, Fiscal Management, Health Insurance, Maternal health, Medicaid, Outcome and process assessment, Pregnancy, State initiatives

Annotation: This issue brief provides strategies and examples of how the Title V program's focus on preventative efforts can leat to long-term health benefits and cost-savings. Preconception care, cesarean-section reduction, prenatal care, maternal smoking cessation newborn screening, breastfeeding promotion, healthy early childhood development, access to medical homes, immunization promotion, and childhood injury prevention are among the preventive measures addressed.

Contact: Association of Maternal and Child Health Programs, 1825 K Street, N.W., Suite 250, Washington, DC 20006-1202, Telephone: (202) 775-0436 Fax: (202) 478-5120 E-mail: [email protected] Web Site: http://www.amchp.org Available from the website.

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Keywords: Child health, Cost containment, Cost effectiveness, Maternal health, Prevention programs, Prevention services, State MCH Programs, Title V programs, Women', s health

Annotation: This action brief provides an overview of payment reform opportunities and steps that health care purchasers can take to adhere to evidence-based practices that improve outcomes for both infants and mothers while decreasing the growth in health care spending for maternity care services. The brief explains how costs associated with pregnancy and its complications, combined with labor and delivery costs, are a driving factor in the rising costs of health care, and points to the absence of evidence that Cesarean deliveries, elective labor inductions, and scheduled deliveries result in improved outcomes. It presents a variety of payment alternatives that can help align incentives for providers and hospitals to adhere to evidence-based practices that improve health outcomes for mothers and infants.

Contact: Catalyst for Payment Reform, E-mail: [email protected] Web Site: http://www.catalyzepaymentreform.org Available from the website.

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Keywords: Cost containment, Health care reform, Infant health, Maternal health, Pregnancy outcome, Program improvement

Annotation: This briefing paper is designed to help legislators, state health policy officials, and other stakeholders think through the decisions they may need to make regarding cost-containment activities in health care coverage programs, with a focus on actions that affect children under Medicaid and the State Children's Health Insurance Program (SCHIP). The paper identifies a menu of cost-containment options that states have considered, along with the pros and cons of those options. The paper identifies differences, where they exist, in the ways states deal with fiscal pressures in Medicaid and SCHIP and also presents options for each program. The paper is organized into three sections. Section I addresses states' fiscal environment and children's health programs. Section II identifies the menu of potential areas for containment. Section III attempts to assist states in evaluating cost containment strategies. The paper ends with a conclusion.

Contact: National Academy for State Health Policy, 10 Free Street, Second Floor, Portland, ME 04101, Telephone: (207) 874-6524 Secondary Telephone: (202) 903-0101 Fax: (207) 874-6527 E-mail: [email protected] Web Site: http://www.nashp.org Available from the website.

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Keywords: Child health, Cost containment, Health care, Medicaid, State children', State programs, s health insurance program

Annotation: This study examines the relationship between state Supplemental Nutrition Program for Women, Infants and Children (WIC) cost-containment practices, program costs, and WIC participant outcomes in six states: California, Connecticut, North Carolina, Ohio, Oklahoma, and Texas. Information on practices and outcomes was collected from program administrative data, interviews with state and local officials, interviews with WIC participants, a survey of WIC food prices and item availability, supermarket transaction data, and focus groups of WIC dropouts. Outcomes in states with certain practices are compared with outcomes in states without those practices. Chapters in the study include the purpose and approach of the study, data sources, state cost-containment practices and their administrative costs, approved foods and food selection, food costs and food cost savings, access to WIC vendors and availability of prescribed foods, participant satisfaction with and use of prescribed foods, WIC participants with special diets or food allergies, food instrument redemption, program participation, health outcomes, and findings by outcome measure and cost-containment practice. Implications for other states are discussed.

Contact: U.S. Department of Agriculture, Economic Research Service, 1800 M Street, N.W., Washington, DC 20036-5831, Telephone: (202) 694-5050 E-mail: infocenterers.usda.gov Web Site: http://www.ers.usda.gov Available from the website. Document Number: E-FAN-03-005.

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Keywords: California, Case studies, Comparative analysis, Connecticut, Cost containment, Costs, Food service, Health care costs, North Carolina, Ohio, Oklahoma, Outcome evaluation, Program participation, Research, State programs, Texas, WIC Program

Annotation: This report describes the results of a 2002 survey of all states and the District of Columbia to identify state Medicaid spending trends, how states are responding to these trends, and their overall fiscal conditions. Chapter topics include an introduction and background in recent Medicaid spending trends; the survey methodology; survey results in these categories: by year, state children's health insurance program, administrative budgets, treatment option and state Olmstead Plan implementations, and outlook. Cost containment efforts by Iowa, Oklahoma, Missouri, and Mississippi are profiled. The report also includes five appendices: (1) survey instrument; (2) 2002 state legislative regular and special session calendar; (3) factors contributing to Medicaid expenditure growth in 2002: state survey; (4) cost containment actions taken in 50 states and the District of Columbia in FY 2002; and (5) cost containment actions taken in 50 states and the District of Columbia in FY 2003.

Contact: Henry J. Kaiser Family Foundation, Washington, DC Office/Public Affairs Center, 1330 G Street, N.W., Washington, DC 20005, Telephone: (202) 347-5270 Fax: (202) 347-5274 E-mail: Web Site: http://www.kff.org/about/bjcc/bjcc_floor.cfm Available at no charge; also available from the website.

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Keywords: : Medicaid, Budgeting, Cost containment, Health insurance, Iowa, Mississippi, Missouri, Oklahoma, State programs, State programs, State surveys, Trends

Annotation: This report examines three states considered to be successfully implementing section 1906 of the Social Security Act, enacted in the Omnibus Budget Reconciliation Act of 1990. The purpose of the report is to determine the extent to which these states are purchasing employer based health insurance for individuals eligible for Medicaid and achieving savings, the cost effectiveness criteria used by the states, outreach efforts, and legislative reforms suggested to improve states' efforts. The states examined are Iowa, Pennsylvania, and Texas.

Contact: U.S. Government Accountability Office, 441 G Street, N.W., Washington, DC 20548, Telephone: (202) 512-3000 Secondary Telephone: E-mail: [email protected] Web Site: http://www.gao.gov Available from the website. Document Number: GAO/HEHS-97-159.

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Keywords: Cost containment, Employee benefits, Health insurance, Iowa, Medicaid, Pennsylvania, Texas

Annotation: This report considers current federal and state Medicaid expenditures as a background for considering state efforts to contain costs and expand coverage by applying for waivers to certain Medicaid requirements. The report includes a summary which highlights the principal findings in addition to detailed analyses of the topic. Implications for future federal spending and on Medicaid's future are also considered.

Contact: U.S. Government Accountability Office, 441 G Street, N.W., Washington, DC 20548, Telephone: (202) 512-3000 Secondary Telephone: E-mail: [email protected] Web Site: http://www.gao.gov Available from the website. Document Number: GAO/HEHS-95-122.

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Keywords: Cost containment, Costs, Economic factors, Expanded eligibility, Federal government, Medicaid, Medicaid managed care, State data, State government, State initiatives, Statistics, Waiver 1115

Annotation: This book contains a collection of essays that consider the conditions of the nation's health and health care system at the beginning of the 1990s. The three main sections of the book focus on health and health care, health policy, and health care reform. Topics given closer consideration within those sections include: health status and its determinants; shaping the health care system; the politics of health; the role of nurses; initiatives for reform; health care cost containment; inequities in access to health services; quality, effectiveness, and appropriateness of care; and a miscellany of neglected issues. There are several essays within each of those specific categories; for example, the neglected issues section includes essays on long term care, racial factors in health care, women's health, the women's health movement, and living with AIDS.

Contact: Jones and Bartlett Learning, 5 Wall Street, Burlington, MA 01803, Telephone: (800) 832-0034 Secondary Telephone: (978) 443-5000 Fax: (978)443-8000 E-mail: [email protected] Web Site: http://www.jblearning.com Available in libraries. Document Number: ISBN 0-86720-840-6.

Keywords: Access to health care, Barriers, Cost containment, Health care systems, Health policy, Health services, Health status, National health care reform, National policy, Nursing, Quality assurance

Annotation: This report considers the assumptions that analysts use to make cost projections for the various proposals that are being considered for reforming the national health care system. It reviews the potential effects of four common provisions that affect the possible reforms: cost containment, managed competition and increasing enrollments in health maintenance organizations, uninsured persons, and administrative changes. The report reviews the analyses that have been made of the proposed reforms to determine how key policies were estimated, and it considers factors that may contribute to the degree of uncertainty that affects the reliability of the estimates. The report includes summaries and indicates possible policy implications.

Contact: U.S. Government Publishing Office, 732 North Capitol Street, N.W., Washington, DC 20401, Telephone: (202) 512-1800 Secondary Telephone: (866) 512-1800 Fax: (202) 512-2104 E-mail: [email protected] Web Site: http://www.gpo.gov Available from the website. Document Number: GPO 052-003-01374-6; ISBN 0-16-045062-4; OTA-H-594.

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Keywords: Administrative policy, Cost containment, Enrollment, Health care costs, Health maintenance organizations, Managed competition, National health care reform, Policy development, Service delivery, Uninsured persons

Annotation: This report presents the results of a survey taken of SPRANS and MCHIP grant recipients to determine the their progress toward implementing the Surgeon General's 1987 action agenda to improve the care and the quality of life for children with special health needs and their families. The report includes the methodology used, and presents the survey results for the five-year period ending in March 1993. The author provides information on the agenda's seven action steps, and contains an overview and detailed tables for each. Appendixes include examples of project activities for each step, data tables, and examples of the survey instruments. This report contains the results of the written survey; a related publication, "Lessons Learned, " contains the results of the telephone survey.

Keywords: Access to care, Children with special health care needs, Community based services, Cost containment, Culturally competent services, Demonstration programs, Families, Family centered services, Health care financing, Information dissemination, Professional education, Program development, Research, SPRANS, Service coordination, Statistics, Survey tools, Surveys

Annotation: This report provides a comprehensive picture of the fundamental policy issues underlying the Medicaid financing crisis. It also presents the findings and conclusions of the Kaiser Commission on the Future of Medicaid of the factors causing the surge in Medicaid spending in the 1988 to 1991 period. The commission concludes that the combined effects of providing care for the poor and vulnerable in an out-of-control medical marketplace underlie these increases, and that solutions to the Medicaid crisis require health care coverage for the poor and persons with disabilities, system wide cost containment, and shared responsibility between state and federal governments.

Contact: Kaiser Program on Medicaid and the Uninsured, 1330 G Street, N.W., Washington, DC 20005, Telephone: (202) 347-5270 Fax: (202) 347-5274 E-mail: http://www.kff.org/about/contact.cfm Web Site: http://kff.org/about-kaiser-commission-on-medicaid-and-the-uninsured/ First copy complimentary, additional copies are $10.00.

Keywords: Cost containment, Health care delivery, Health care financing, Health care reform, Health policy, MCH services, Medicaid, Public health programs, Public health services, Public policy, Socioeconomic factors

Annotation: This paper looks at a managed care/injury prevention partnership in Contra Costa County, California. It sees benefits, especially primary injury prevention, that can realize large cost savings as the state of California converts from its fee-for-service MediCal system to a system of contracts with local providers. Prevention efforts include education and the development of policies aimed at changing environmental conditions.

Contact: Contra Costa County Health Services , Community Wellness & Prevention Program, 597 Center Avenue- Suite 115, Martinez, CA 94553, Telephone: (925) 313-6808 Fax: (925) 313-6840 Web Site: http://www.cchealth.org/groups/prevention/ Available at no charge.

Keywords: California, Contract services, Cost containment, Injury prevention, Managed care, Medicaid, Medicaid managed care, Program descriptions, State programs

Annotation: This report examines managed care program initiatives developed by state governments, focusing on states' use of managed care programs; the difficulty states face in implementing certain program components; the effect of the managed care approach on health care access, quality, and cost; and the presence of features that assure the quality of health services and providers' financial stability. Appendices include detailed examinations of programs in Arizona, Kentucky, Michigan, Minnesota, New York, and Oregon.

Contact: U.S. Government Accountability Office, 441 G Street, N.W., Washington, DC 20548, Telephone: (202) 512-3000 Secondary Telephone: E-mail: [email protected] Web Site: http://www.gao.gov Available from the website. Document Number: GAO/HRD-93-46.

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Keywords: Access to health care, Consumer education, Cost containment, Enrollment, Insurance, Medicaid managed care, Provider participation, Public health infrastructure, Quality assurance, State government, State programs, Waiver programs

Annotation: This report analyzes the cesarean section rate in the United States for the period 1989-1990. It includes discussions of cesarean safety for both the mother and child, the clinical reasons given for performing cesareans, the nonmedical factors linked to cesarean operations, and the development of clinical guidelines for both cesarean sections and vaginal births after cesarean sections. Charts list cesarean rates for 48 states plus the District of Columbia as well as the number of cesarean operations performed at 2,657 U.S. hospitals during that time period. Sets of questions for consumers to use with obstetricians and hospital administrators are included along with a model for maternity information legislation.

Contact: Public Citizen's Health Research Group, 1600 20th Street, N.W., Washington, DC 20009, Telephone: (202) 588-1000 Web Site: http://www.citizen.org/hrg/ Available in libraries.

Keywords: Cesarean section, Childbirth, Cost containment, Dystocia, Fetal distress, Guidelines, Legislation, Malpractice insurance, Maternal health, Mortality, Newborn infants, Repeat cesarean birth, Vaginal birth after cesarean

Annotation: This report identifies areas in which family planning program costs can be reduced and services made more attractive to clients without compromising quality care. The information is also useful to states in implementing Title X of the Public Health Service Act.

Contact: U.S. Government Accountability Office, 441 G Street, N.W., Washington, DC 20548, Telephone: (202) 512-3000 Secondary Telephone: E-mail: [email protected] Web Site: http://www.gao.gov Available from the website. Document Number: HRD-81-68.

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Keywords: Cost containment, Family planning, Public Health Service Act, Title X

Annotation: This guide is designed to help school food service managers to control food costs in menu planning. It offers guidance on selecting economical foods and provides instructions for precosting individual food items (including donations from the U.S. Department of Agriculture), recipes, and complete menus. Included are measurement unit conversion tables to assist in calculating individual serving costs when handling bulk food supplies.

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Keywords: Child nutrition, Cost containment, Economics., Food, School lunch programs

Annotation: This forum presented broad perspectives and opposing points of view concerning the changing roles of the public and private sectors in health care. Because of widespread legislative and public interest in national health insurance, the specific focus was the issues of control and regulation. The participants discussed four broad topics: planning systems, cost containment, quality assurance, and manpower distribution. Each of these was discussed from the aspect of providers, consumers, governments, and the private/volunteer sector.

Keywords: Conferences, Consumers, Cost containment, Costs, Evaluation, Government, Health personnel, Health planning, Health planning, Health services, National Health Council, Private sector, Quality assurance, United States