Search Results: MCHLine

Annotation: This report presents the proceedings of the annual Public Health Social Work Maternal and Child Health Institute held in April 1989, in Pittsburgh. Presentations covered issues and directions for case management, case management in specific situations (multiply diagnosed children, pediatric AIDS in Belle Glade, Florida, prenatal care, and primary care), quality assurance, management information systems, training in case management, and a community development approach to case management in Pittsburgh. [Funded by the Maternal and Child Health Bureau]

Contact: Maternal and Child Health Library at Georgetown University, E-mail: [email protected] Web Site: https://www.mchlibrary.org Available from the website.

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Keywords: Case management, Conference proceedings, Primary care, Social work

Annotation: The goal of this project was to improve the overall system of health care delivery for West Virginia children with special health needs. Specific goals were to: (1) Provide individualized family empowerment training with specific emphasis on skills in case management; (2) strengthen the Handicapped Children's Services system of case management; (3) provide coordinated, comprehensive medical and educational evaluations for children with special health needs; (4) establish a movement recognizing parents as equal partners within the professional team; (5) enhance networking through a parent-provider interdisciplinary, interagency conference; (6) identify a primary medical home for every child with special health needs; (7) emphasize the role of the primary care physician as a member of the community team; (8) assure continuation of the project beyond the funding period; and (9) expand services to all children with special health needs in West Virginia. [Funded by the Maternal and Child Health Bureau]

Contact: National Technical Information Service, O.S. Department of Commerce, 5301 Shawnee Road, Alexandria, VA 22312, Telephone: (703) 605-6050 Secondary Telephone: (888) 584-8332 E-mail: [email protected] Web Site: http://www.ntis.gov Document Number: NTIS PB97-121867.

Keywords: Access to Health Care, Case Management, Children with Special Health care Needs, Families, Family Professional Collaboration, Interagency Cooperation, Medical Home, PL 99-457, Parent Professional Communication, Parents, Primary Care, Service Coordination

Annotation: This report presents case study findings on successes and challenges related to incorporating oral health care into accountable care organizations (ACOs) in Iowa, Minnesota, Oregon, and Southwest Washington. Each case study provides the ACO’s background and market overview and describes payment arrangements and risk-sharing, care coordination, provision of oral health care, challenges to oral health care provision, and results.

Contact: American Dental Association, Health Policy Institute, 211 East Chicago Avenue, Chicago, IL 60611-2678, Telephone: (312) 440-2500 Web Site: http://www.ada.org/en/science-research/health-policy-institute Available from the website.

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Keywords: Accountability, Case studies, Children, Coordination, Dental care, Health services delivery, Model programs, Oral health, Patient care management, Pregnant women, Primary care, Quality assurance, Reimbursement, Service integration, State programs

Annotation: This issue brief summarizes findings from a Child Health Insurance Research Initiative study of the impact of implementing primary care case management (PCCM) systems in Alabama and Georgia. PCCM systems aim to increase the use of well-child and primary care in physicians' offices while decreasing use of specialty care and emergency departments. Policy implications of what was learned from the study are included.

Contact: U.S. Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD 20857, Telephone: (301) 427-1364 Web Site: http://www.ahrq.gov Available from the website. Document Number: AHRQ Pub. No. 09-0020.

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Keywords: Alabama, Case management, Emergency medical services, Georgia, Health care systems, Primary care, Public policy, Research, State programs, Well child care

Annotation: This brochure provides questions -- derived from interviews with 41 managed care plans across the nation conducted to learn about programs and policies and to share information about resources for children with special health care needs (CSHCN) -- that can be used as a starting point for discussions between families and managed care plans examining current systems of care and initiating improved programs and policies for CSHCN. Topics include identifying CSHCN, ensuring appropriate care, primary care and specialty care referrals, care coordination and case management, mental health and behavioral health services, resolving disagreements about care, and involving families of CSHCN in policy and program activities. For each topic, a list of questions is included.

Contact: Federation for Children with Special Needs, 529 Main Street, Suite 1102, Boston, MA 02120, Telephone: (617) 236-7210 Secondary Telephone: (800) 331-0688 Fax: (617) 241-0330 E-mail: [email protected] Web Site: http://www.fcsn.org Available at no charge; also available from the website.

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Keywords: Behavior problems, Case management, Children with special health care needs, Conflict resolution, Families, Interviews, Managed care, Primary care, Programs, Referrals, Service coordination, Systems of care

Annotation: This paper describes a study conducted to examine the effects of Medicaid managed care on prenatal care utilization and infant health. Topics include estimating the effect of primary care case management (PCCM) managed care programs and health maintenance organization (HMO) managed care plans on prenatal care utilization, birth weight, and cesarean section. The paper includes sections discussing previous research; the empirical model and statistical methodology used in the study, the data, and results; and a final section reviewing study findings. Statistical information is presented in tables throughout the paper and in the appendix. A reference list is provided.

Contact: National Bureau of Economic Research, 1050 Massachusetts Avenue, Cambridge, MA 02138-5398, Telephone: (617) 868-3900 Fax: (617) 868-2742 E-mail: [email protected] Web Site: http://www.nber.org Available from the website.

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Keywords: Case management, Cesarean section, Evaluation, Health care delivery, Health care utilization, Health maintenance organizations, Infant health, Low birthweight, Medicaid managed care, Prenatal care, Primary care

Annotation: This report is the third in a series analyzing state Medicaid managed care trends. It presents information on states' Medicaid managed care enrollment policies in effect at the end of 1999 and the extent to which state policies have changed over the four-year period from 1996 to 1999. It examines states' use of both primary care case management (PCCM) and managed care organization (MCO) arrangements. It includes information on states that have opted for mandatory enrollment of children eligible for Medicaid into managed care without a federally approved waiver. Tables at the end of the report show states' mandatory and voluntary enrollment policies for PCCMs and MCOs by child eligibility group for 1999. Additional tables show, for the years 1996-1999, states' mandatory and voluntary enrollment policies for managed care combined by child eligibility group; states' managed care enrollment policies affecting children; states mandatory and voluntary enrollment policies for PCCMs combined by child eligibility group; and states' mandatory and voluntary enrollment policies for MCOs combined by child eligibility group. [Funded by the Maternal and Child Health Bureau]

Keywords: Case management, Child health, Children, Managed care, Medicaid managed care, Primary care, State health insurance programs

Annotation: This manual looks at the current health financing and child welfare systems that provide health care to children in foster care and suggests alternatives within a fee for service structure and within a risk-based capitated structure. An appendix summarizes the alternatives in a table and provides definitions of managed care organizations.

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 Price unknown.

Keywords: Capitation, Child welfare, Children with special health care needs, EPSDT, Foster care, Foster children, Health maintenance organizations, Managed care, Models, Primary case care management, Service delivery, Service delivery systems

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Keywords: Awards, Case management, Community health services, Health promotion, Home visiting, Illinois, Minority groups, Model programs, Models That Work, Outreach, Primary care, Primary care, Public private partnerships, Underserved communities

Annotation: This book details the similarities and differences of 25 Medicaid managed care initiatives and makes cross-program comparisons regarding cost-effectiveness and utilization. The authors discuss the history of primary care case management (PCCM), the concept of gatekeeping in primary care, and the classification of the different types of Medicaid managed care plans. A review of cost and usage data follows an assessment of the strengths and limitations of evaluation efforts to date. An appendix of program descriptions includes the sources for the data, program abstracts, and descriptions of each program's evaluation methodology, findings, and assessment criteria.

Keywords: Case management, Cost effectiveness, Data collection, Evaluation, Medicaid managed care, Primary care, State health care reform, Statistics, Utilization review

Annotation: This report gives the results of an examination of the Healthy Moms, Healthy Kids program in Chicago, Illinois to determine if the program had adequate management controls and to identify challenges to successful implementation of the program. This program, which uses a primary care case management (PCCM) model of managed care, is similar to traditional fee-for-service programs except that providers receive a per capita management fee to coordinate a client's care. Pregnant women and children eligible for Medicaid have the option of enrolling in this program or a health maintenance organization.

Contact: U.S. Government Accountability Office, 441 G Street, N.W., Washington, DC 20548, Telephone: (202) 512-3000 E-mail: [email protected] Web Site: http://www.gao.gov Available from the website. Document Number: GAO/HRD-93-121.

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Keywords: Access to health care, Accountability, Case management, Child health, Illinois, Maternal health, Medicaid managed care, Primary care, Primary care, Program evaluation, Quality assurance

Annotation: This manual suggests guidelines for implementing and monitoring fee-for-service primary case management (PCCM) programs operated by state Medicaid agencies. The manual provides information to state Medicaid agencies that are considering implementing PCCM programs and is designed to encourage states to continuously improve the quality of care delivered through PCCM programs. A sample state utilization review system in included in an appendix.

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Keywords: Case management, Medicaid managed care, Primary care

Annotation: This report describes the procedures that were used to establish a community-based ambulatory care network in Rochester, New York. The project explored techniques for collecting and organizing clinical information in networked practices with the intent of integrating that information with other data that is routinely collected; it also sought to investigate the primary care practices of the physicians who participated in the network. The report contains information on the development of the physician network, the technical aspects of designing the network and the database, examines patterns of outpatient care, and presents information on clinical outcome management and community-based ambulatory care. The report considers the lessons learned in the study and presents information on the current status and future plans for the network. It was funded by a grant from the John A. Hartford Foundation to the University of Rochester.

Keywords: Case management, Community based services, Health professionals, Integrated information systems, Medical practices, New York, Primary care, Primary care