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Strengthening the evidence for maternal and child health programs

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Items in this list may be obtained from the sources cited. Contact information reflects the most current data about the source that has been provided to the MCH Digital Library.


Displaying records 1 through 20 (205 total).

Honsberger K, Eichner H. 2018. How states use the national standards for CYSHCN to strengthen Medicaid managed care for children with special health care needs. Portland, ME: National Academy for State Health Policy,

Annotation: This fact sheet provides examples of state actions to use the National Standards for Children and Youth with Special Health Care Needs (CYSHCN) to strengthen their managed care systems for CYSHCN. Topics include analyzing and enhancing specialized managed care plans, providing a framework to design and strengthen care delivery systems, strengthening contract language to address the needs of CYSHCN, and improving care coordination and transition to adult care. The various state examples outlined here resulted from a 12-month learning collaborative facilitated by NASHP, in partnership with the Association of Maternal & Child Health Programs (AMCHP), with support from the Lucile Packard Foundation for Children’s Health (LPFCH).

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: info@nashp.org Web Site: http://www.nashp.org Available from the website.

Keywords: Adolescents with special health care needs, Children with special health care needs, Managed care, Medicaid, Standards, State programs, Title V programs, Young adults

National Heath Law Program. 2017. Early and Periodic Screening, Diagnostic, and Treatment. Washington, DC: National Health Law Program,

Annotation: This website provides information about Medicaid's Early and Periodic Screening, Diagnostic, and Treatment Program (EPSDT), including a clickakable map of state EPSDT information, videos with basic introduction to Medicaid's Early Periodic Screening, Diagnostic, and Treatment benefit and how it can interact with the Individuals with Disabilities Education Act to cover services provided in schools, and publications on the topic from NHELP,

Contact: National Health Law Program, 1441 I Street, N.W., Suite 1105, Washington, DC 20005, Telephone: (202) 289-7724 E-mail: nhelp@healthlaw.org Web Site: http://www.healthlaw.org Available from the website.

Keywords: Access to health care, Barriers, Child health insurance, EPSDT, Health care utilization, Health services delivery, Medicaid managed care, Provider networks, Regulations, Standards, State programs, Third party payers

Association of Maternal and Child Health Programs. 2017. National Title V children and youth with special health care needs program profile. Washington, DC: Association of Maternal and Child Health Programs, 15 pp.

Annotation: This report provides a snapshot of Title V Children and Youth with Special Health Care Needs (CYSHCN) programs across the United States. Contents include background and history of CYSHCN programs, recent changes affecting CYSHCN programs, and methods and results from an electronic survey of Title V CYSHCN directors to assess key characteristics of each state's CYSHCN program. Topics include program structure and strengths, roles in systems of care, CYSHCN program partnerships, financing of care for CYSHCN populations and emerging issues for CYSHCN programs.

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: info@amchp.org Web Site: http://www.amchp.org Available from the website.

Keywords: Advocacy, Children with special health care needs, Community based services, Consultation, Cultural competency, Data, Family centered care, Financing, Health care delivery, Health care reform, Health care systems, Health insurance, Leadership, Medicaid managed care, Models, Networking, Pediatric care, Policy development, Program coordination, Program development, Public health infrastructure, Public private partnerships, Quality assurance, Reimbursement, Role, Standards, State MCH programs, Title V programs

Connecticut Dental Health Partnership. 2017. Dental care for pregnant women in HUSKY A. Farmington, CT: Connecticut Dental Health Partnership, 11 pp. (Connecticut's Perinatal and Infant Oral Health Quality Improvement Project)

Annotation: This report describes a study that estimated the impact of the Perinatal and Infant Oral Health Quality Improvement Project on oral health services utilization by pregnant women in Connecticut’s HUSKY Program, the state’s health care coverage program that provides low-cost or free comprehensive coverage for families or single adults with low incomes. The report provides background about Medicaid eligibility, the Medicaid dental benefit, managed care, and perinatal outreach in Connecticut. The report also discusses study methods, data, and the analytic approach and presents results. [Funded by the Maternal and Child Health Bureau]

Contact: Connecticut Dental Health Partnership, 195 Scott Swamp Road, Farmington, CT 06032, Telephone: (860) 507-2302 Web Site: https://www.ctdhp.com/default.asp

Keywords: Connecticut, Dental care, Health care utilization, Low income groups, Managed care, Medicaid, Oral health, Perinatal care, Pregnant women, State programs

U.S. Department of Health and Human Services. 2016. 2015 annual report on the quality of care for children in Medicaid and CHIP. Washington, DC: U.S. Department of Health and Human Services, 42 pp.

Annotation: This report shows the progress made by the U.S. Department of Health and Human Services and states to systematically measure and report on the quality of care that children enrolled in Medicaid and the Children's Health Insurance Program (CHIP) receive. Contents include information about state-specific findings on quality and access in Medicaid and CHIP and monitoring and improving care for children enrolled in managed care. Topics include primary care access and preventive care, management of acute and chronic conditions, childhood obesity, oral health care, prenatal and postpartum care, and adolescent well care.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (877) 267-2323 Secondary Telephone: (410) 786-3000 Fax: Web Site: https://www.cms.gov Available from the website.

Keywords: Access to health care, Adolescent health, Child health, Children's Health Insurance Program, Federal programs, High risk children, Managed care, Measures, Medicaid, Nutrition, Oral health, Perinatal health, Preventive health services, Primary care, Program improvement, Progress reports, Quality assurance, State programs

U.S. Centers for Medicaid & Medicare Services. 2016. Dental and oral health services in Medicaid and CHIP. [Baltimore, MD: Centers for Medicaid & Medicare Services], 30 pp.

Annotation: This report provides state-specific findings on children's use of dental services in Medicaid and the Children's Health Insurance Program. It includes state-specific performance data for two measures: preventive dental services and dental treatment services. The report also summarizes information on managed care quality-monitoring and qaulity-improvement efforts related to oral health care that were reported in states' external quality review technical reports.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (877) 267-2323 Secondary Telephone: (410) 786-3000 Fax: Web Site: https://www.cms.gov Available from the website.

Keywords: Children, Children’s Health Insurance Program, Health care utilization, Managed care, Medicaid, Oral health, Preventive health services, Program improvement, Quality assurance, State programs, Statistical data, Trends

U.S. Department of Health and Human Services. 2016. 2015 annual report on the quality of health care for adults in Medicaid. Washington, DC: U.S. Department of Health and Human Services, 43 pp.

Annotation: This report summarizes information on the quality of health care provided to adults covered by Medicaid, including pregnant women. The report discusses the status of quality measurement and reporting efforts using the Medicaid Adult Core Set and summarizes information on managed care performance measures and performance-improvement projects reported in external quality-review technical reports that states submitted to the Centers for Medicare & Medicaid Services. Topics include diabetes care, hospital readmissions, emergency department visits, and substance use disorders.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (877) 267-2323 Secondary Telephone: (410) 786-3000 Fax: Web Site: https://www.cms.gov Available from the website.

Keywords: Access to health care, Adults, Federal programs, Managed care, Measures, Medicaid, Pregnant women, Program improvement, Progress reports, Quality assurance, Reports, State programs

U.S. Department of Education. 2016. Healthy students, promising futures: State and local action steps and practices to improve school-based health. Washington, DC: U.S. Department of Education, 16 pp.

Annotation: This toolkit contains information that details five high impact opportunities for states and local school districts to support communities through collaboration between the education and health sectors, highlighting best practices and key research in both areas. Contents include resources, programs, and services offered by non-governmental organizations.

Contact: U.S. Department of Education, 400 Maryland Avenue, S.W., Washington, DC 20202, Telephone: (800) 872-5327 Secondary Telephone: (800) 437-0833 Web Site: http://www.ed.gov Available from the website.

Keywords: Case management, Collaboration, Communities, Community action, Educational reform, Eligibility, Health care reform, Health education, Health insurance, Health services delivery, Hospitals, Medicaid managed care, Needs assessment, Nutrition, Physical activity, Public private partnerships, Reimbursement, Role, School districts, State government, Students

National Health Care for the Homeless Council and United Health Care Community & State. 2016. Managed care and homeless populations: Linking the HCH community and MCO partners. Nashville, TN: National Health Care for the Homeless Council, 9 pp.

Annotation: This policy brief is intended to serve as a resource for managed care entities looking to better understand homelessness, for health professionals seeking to be more aware of managed care and its interests, and for both groups to better understand the common goals each brings to a partnership. The brief includes the health care needs of people who are homeless, describes Health Care for the Homeless projects and the patients receiving care in these venues, a description of managed care, common goals between both entities, and issues that both providers and plans should consider when creating or strengthening partnerships.

Contact: National Health Care for the Homeless Council, P.O. Box 60427, Nashville, TN 37206-0427, Telephone: (615) 226-2292 Fax: (615) 226-1656 E-mail: council@nhchc.org Web Site: http://www.nhchc.org Available from the website.

Keywords: Health insurance, Homeless persons, Homelessness, Managed care, Medicaid managed care, Public private partnerships

Snyder A, Kaye N, Mention N. 2016. Managed care for Medicaid dental services: Insights from Kentucky. Portland, ME: National Academy for State Health Policy, 18 pp.

Annotation: This brief describes Kentucky’s experience administering a dental benefit through its managed care contract. The brief outlines the evolution of the state’s approach to dental benefits; highlights practices that state officials and managed care plans are taking to ensure health professional network adequacy and enrollee access to care; discusses challenges that the state, managed care organizations, and health professionals have encountered; and suggests potential options that the state could explore as it pursues future improvement.

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: info@nashp.org Web Site: http://www.nashp.org Available from the website.

Keywords: Access to health care, Children, Dental care, Dental insurance, Kentucky, Medicaid managed care, Oral health, Policy development, Pregnant women, Program improvement, Provider participation, Quality assurance, State programs

McKee C. 2016. Medicaid managed care final regulations and reproductive care. Washington, DC: National Health Law Program, 7 pp. (Issue brief no. 5)

Annotation: This brief reviews implementation requirements governing access to reproductive health services in Medicaid managed care. Topics include network adequacy and access to services, travel time and distance standards, timely availability of services, direct access to providers, information requirements, and utilization controls. Recommendations for states are also included.

Contact: National Health Law Program, 1441 I Street, N.W., Suite 1105, Washington, DC 20005, Telephone: (202) 289-7724 E-mail: nhelp@healthlaw.org Web Site: http://www.healthlaw.org Available from the website.

Keywords: Access to health care, Barriers, Health care utilization, Health services delivery, Medicaid managed care, Provider networks, Regulations, Reproductive health, Standards, Third party payers, Women's health

National Academy for State Health Policy. 2016. State strategies for promoting children's preventive services. Portland, ME: National Academy for State Health Policy, multiple items.

Annotation: This series of maps and the accompanying chart illustrate state-specific Medicaid or Children’s Health Insurance Program performance-improvement projects, measures, or incentives promoting children’s preventive services. The series covers managed or accountable care performance-improvement projects; managed care performance measures; metrics or incentives in statewide Medicaid system transformation; other financial incentives; and non-financial incentives. Measures, projects, and incentives fall into the following six categories of services: behavioral health screenings, weight assessment, lead screening, immunizations, preventive oral health services, and well visits for children and adolescents. [Funded by the Maternal and Child Health Bureau]

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: info@nashp.org Web Site: http://www.nashp.org Available from the website.

Keywords: Accountability, Adolescents, Body weight, Children, Children's Health Insurance Program, Financing, Health care reform, Measures, Medicaid managed care, Medical home, Mental health, Oral health, Preventive health services, Program improvement, Quality assurance, Reimbursement, Screening, State programs, Systems development

Centers for Medicare & Medicaid Services. 2016. Perinatal care in Medicaid and CHIP. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 5 pp. plus appendices.

Annotation: This report provides state-specific findings on perinatal care in Medicaid and the Children's Health Insurance Program. Contents include state-specific performance data on 5 of the 10 perinatal care measures in the Child and Adult Core Sets. The report also summarizes information on managed care quality monitoring and improvement efforts related to prenatal and postpartum care that were reported in states' external quality review technical reports. Topics include timeliness of prenatal care, frequency of ongoing prenatal care, postpartum care rate, live births weighing less than 2,500 grams (low birthweight), and central-line-associated blood stream infections in neonatal intensive care units.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (877) 267-2323 Secondary Telephone: (410) 786-3000 Fax: Web Site: https://www.cms.gov Available from the website.

Keywords: Children's Health Insurance Program, Health care utilization, Measures, Medicaid managed care, Perinatal care, Postpartum care, Prenatal care, Program improvement, Progress reports, Quality assurance, State programs, Statistical data, Utilization review

Heider F, Wirth B, Kuznetsov RD. 2016. Medicaid managed care: Challenges and opportunities for pediatric medical home implementation and children and youth with special health care needs. Elk Grove Village, IL: National Center for Medical Home Implementation, 5 pp.

Annotation: This fact sheet for Title V programs, clinicians, and family leaders provides information about the potential effect of Medicaid and Children's Health Insurance Program (CHIP) managed care on children and youth with special health care needs (CYSHCN) and their families. Topics include requirements for managed care organizations in CHIP and opportunities to mitigate potential unintended negative consequences of Medicaid managed care for CYSHCN and their families. Promising practices and strategies from states are included. [Funded by the Maternal and Child Health Bureau]

Contact: National Center for Medical Home Implementation, American Academy of Pediatrics, 345 Park Boulevard, Itasca, IL 60143, Telephone: (847) 434-7605 Secondary Telephone: (800) 433-9016, ext. 7605 Web Site: https://medicalhomeinfo.aap.org/Pages/default.aspx Available from the website.

Keywords: Children, Contract services, Enrollment, Family centered care, Health care delivery, Health care reform, Medicaid managed care, Medical home, Model programs, Primary care, Service delivery systems, Special health care needs, State MCH programs, Youth

Moore JE, Hernandez AA, Lanier E. 2016. Building a culture of health in childhood obesity: Overview & action plan for Medicaid health plans. Washington, DC: Institute for Medicaid Innovation, 83 pp.

Annotation: This toolkit describes initiatives developed by Medicaid managed care organizations (MMCOs) to prevent and treat childhood obesity and offers resources and tools to support future efforts. Contents include an environmental scan of childhood obesity efforts led by MMCOs, case studies of childhood obesity initiatives and perspectives from families and children, and a readiness assessment and implementation tools to guide MMCOs seeking to enhance their existing initiative(s) or to launch a new program through the design, implementation, and evaluation process.

Contact: Institute for Medicaid Innovation, 1150 18th Street, N.W., Suite 1010, Washington, DC 20036, E-mail: info@medicaidinnovation.org Web Site: http://www.medicaidinnovation.org Available from the website.

Keywords: Case studies, Child health, Diffusion of innovation, Disease prevention, Medicaid managed care, Needs assessment, Obesity, Pediatric care, Prevention programs, Program development, Program evaluation, Program planning, Resources for professionals

Palmer A, McMorrow S, Kenney GM. 2015. Risk-based managed care in New Hampshire's Medicaid program: A qualitative assessment of implementation and beneficiary experiences in year one. Washington, DC: Urban Institute, 47 pp.

Annotation: This report provides an overview of managed care implementation in New Hampshire. The report examines early experience with the implementation of managed care for Medicaid acute care services. Contents include background; methods (case study interviews, focus groups, and limitations); a summary of findings; and conclusions. Topics include the evolution of the implementation timeline and managed care plan participation, enrollment, state oversight experience, provider experiences, case management, beneficiary experience, and implications for phase-in of long-term services and supports.

Contact: Urban Institute, 2100 M Street, N.W., Washington, DC 20037, Telephone: (202) 833-7200 Fax: (202) 467-5775 E-mail: http://www.urban.org/about/contact.cfm Web Site: http://www.urban.org Available from the website.

Keywords: Case studies, Health services delivery, Medicaid managed care, Program evaluation

Mahadevan R, Chazin S. 2015. Medicaid oral health performance improvement projects: A how-to-manual for states. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 34 pp.

Annotation: This manual for state Medicaid agency staff provides guidance on developing and implementing oral-health-performance-improvement projects (PIPs). Topics include selecting the PIP topic, identifying the population, defining the PIP aim, selecting performance measures, establishing the data-collection plan, planning the intervention, implementing the intervention and improvement strategies, analyzing data to interpret PIP results, and planning for sustained improvement. A customizable template and a manual for health plans are also available.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (877) 267-2323 Secondary Telephone: (410) 786-3000 Fax: Web Site: https://www.cms.gov Available from the website.

Keywords: Children, Children's health insurance programs, Manuals, Medicaid managed care, Oral health, Program development, Program evaluation, Program improvement, Program planning, Quality assurance, State programs

Mahadevan R, Chazin S. 2015. Medicaid oral health performance improvement projects: A how-to-manual for health plans. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 51 pp.

Annotation: This manual for health plan staff provides guidance on developing and implementing Medicaid oral-health-performance-improvement projects (PIPs). Topics include selecting the PIP topic, identifying the population, defining the PIP aim, selecting performance measures, establishing the data-collection plan, planning the intervention, implementing the intervention and improvement strategies, analyzing data to interpret PIP results, and planning for sustained improvement. A customizable template and a manual for state Medicaid agency staff are also available.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (877) 267-2323 Secondary Telephone: (410) 786-3000 Fax: Web Site: https://www.cms.gov Available from the website.

Keywords: Children, Children's health insurance programs, Manuals, Medicaid managed care, Oral health, Program development, Program evaluation, Program improvement, Program planning, Quality assurance, State programs

Mahadevan R, Chazin S. 2015. Medicaid oral health performance improvement projects: A template. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 15 pp.

Annotation: This document for state Medicaid agency staff describes an approach for developing and implementing oral-health-performance-improvement projects (PIPs). Contents include a template that can be customized for the planning, implementation, and evaluation phases of an oral health PIP. The appendices contain tools for health plans and a glossary of terms. Accompanying manuals for states and health plans provide guidance on completing the template and pursuing activities in each phase.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (877) 267-2323 Secondary Telephone: (410) 786-3000 Fax: Web Site: https://www.cms.gov Available from the website.

Keywords: Children, Children's health insurance programs, Manuals, Medicaid managed care, Oral health, Program development, Program evaluation, Program improvement, Program planning, Quality assurance, State programs

American Dental Association. 2015. Medicaid: Considerations when working with the state to develop an effective RFP/dental contract. Chicago, IL: American Dental Association, 15 pp.

Annotation: This toolkit for state dental associations and Medicaid programs focuses on key diagnostic elements to consider when developing a dental program contract. Topics include ensuring an adequate network, enrollment and credentialing, securing the dentist-patient relationship, continuity of care, fee schedule and reimbursement, claims processing and appeals, the role of peers in resolving issues, monitoring education and outreach, coordination of care, contractor administrative performance monitoring, use and quality of care for enrolled populations, use management, member and provider manuals, and medical necessity and processing policies.

Contact: American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611-2678, Telephone: (312) 440-2500 Fax: (312) 440-7494 E-mail: info@ada.org Web Site: http://www.ada.org Available from the website.

Keywords: Contract services, Diagnostic techniques, Fiscal management, Legal responsibility, Medicaid managed care, Model programs, Oral health, Policy development, Program coordination, Program development, Program improvement, Quality assurance, Reimbursement, State programs, Utilization review

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.