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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 13 (13 total).

Boynes S, Davis L, Adams G, Mills M, Deutchman M. 2017. MORE Care: Narrowing the rural interprofessional oral health care gap. Westborough, MA: DentaQuest Institute, 35 pp., exec. summ. (10 pp.)

Annotation: This paper provides information about initiating interprofessional networks that integrate and coordinate person-centered oral health care in rural communities. Topics include oral health as a national issue with rural implications, interprofessional practice and the oral-systemic health connection, creating networks and a learning collaborative, state offices of rural health and medicaloral expanded care initiation, and challenges and opportunities for innovation. Examples from Colorado, Pennsylvania, and South Carolina are included.

Keywords: Collaboration, Colorado, Community based services, Health care delivery, Information systems, Oral health, Oral health care, Pennsylvania, Program coordination, Provider networks, Rural environment, Rural health, Rural population, Service integration, South Carolina, State initiatives, Systems development, Technology, Work force

University of Iowa, Public Policy Center. 2016. Dental Wellness Plan evaluation. Iowa City, IA: University of Iowa, Public Policy Center, multiple items.

Annotation: These reports analyze administrative, health professional, and member survey data from a dental insurance plan for adults ages 19–64 with low incomes in Iowa. Contents include information about the plan's benefit structure and member and health professional incentives, the study populations and methodology, and interim outcomes. Topics include access to care, quality of care, cost, earned benefits, health-professional-network adequacy, health professional attitudes, and member outreach.

Keywords: Access to health care, Adults, Client satisfaction, Dental insurance, Dentists, Iowa, Low income groups, Medicaid, Model programs, Oral health, Program evaluation, Provider networks, Provider participation, 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.

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

Louisiana Department of Health and Hospitals. 2015. Dental benefit plan manager: Systems companion guide. Baton Rouge, LA: Louisiana Department of Health and Hospitals, 190 pp.

Annotation: This document provides guidance to Medicaid-contracted dental benefit plan managers on submitting encounters (records of procedures and services provided to Medicaid recipients enrolled in the plan) to the Louisiana Department of Health and Hospitals. Topics include responsibilities, transaction instructions, denial edit codes and descriptions, electronic data interchange certification and testing, data management of file and encounter submissions, continuous quality improvement, data assessment, adjustment process, and Medicaid administrative retroactive enrollment correction process.

Keywords: Contract services, Dental insurance, Fiscal management, Louisiana, Low income groups, Medicaid, Oral health, Oral health care, Provider networks, Quality assurance, Service delivery systems, State programs

Bruner C, Cardenas'Chaisson A. 2015. Collaborative models with a focus upon pediatric practice and child health . Boston, MA: Learning Collaborative on Health Equity and Young Children, 9 pp.

Odeh M. [2014]. Ensuring adequate marketplace provider networks: What's needed for children. Washington, DC: First Focus, 4 pp.

Annotation: This document addresses the adequacy of provider networks in ensuring that all children have access to health services, including oral health services. The document discusses what constitutes adequate provider networks for children and discusses how such networks can be developed and assessed.

Keywords: Access to health care, Advocacy, Children, Health care reform, Provider networks

Mitts L. 2013. Principles for consumer-friendly value-based insurance design. Washington, DC: Families USA, 6 pp.

National Infant and Toddler Child Care Initiative, Early Head Start National Resource Center at Zero to Three. [2011]. Developing a statewide network of infant and toddler specialists: Technical assistance manual for states and territories. Washington, DC: Zero to Three, 36 pp.

Annotation: This manual focuses on developing statewide networks of infant/toddler specialists (ITSNs) who can work directly with the childcare workforce to increase their skills and knowledge. The manual explores the issues that have contributed to the interest in statewide infant/toddler specialist networks; provides a framework for a step-by-step approach to create a network; emphasizes the importance of linking the network to other programs, quality initiatives, and consultant networks; and provides examples and resources for states that are developing, implementing, and evaluating an ITSN. The appendices include examples from state programs in Ohio, North Carolina, and New Jersey, along with a sample ITSN action plan.

Keywords: Child care, Infants, Manuals, Program development, Provider networks, State programs, Technical assistance, Toddlers

Stavrakos JC, Summerville G, Johnson LE. 2009. Growing what works: Lessons learned from Pennsylvania's Nurse-Family Partnership Initiative. Philadelphia, PA: Public/Private Ventures, 42 pp.

Annotation: This report, which focuses on the Pennsylvania Nurse-Family Partnership Initiative, provides lessons for policymakers and funders interested in bringing proven models of home visiting to a statewide scale. The report emphasizes the importance of capitalizing on the unique advantage of geographic proximity to build a network of sites. Topic include (1) reasons to replicate the nurse family partnership, (2) bringing the nurse-family partnership to scale in Pennsylvania, and (3) lessons learned.

Keywords: Community programs, Families, Financing, Home visiting, Initiatives, Model programs, Nurses, Pennsylvania, Provider networks, Public policy, State programs

Fox HB, McManus MA, Limb SJ. 2000. Access to care for S-CHIP children with special health needs. Washington, DC: Kaiser Commission on Medicaid and the Uninsured, 50 pp.

Annotation: This report examines access to care for children with special health care needs under the State Children's Health Insurance Program (SCHIP). It describes a study of SCHIP programs in five states; California, Connecticut, Utah, Maryland, and Missouri. The goal was to understand how program arrangements and plan requirements influence the delivery and quality of care for SCHIP participants and the ease of program implementation for states. The report is divided into five sections. The first provides a profile of the population of children with special health care needs. The second summarizes the special SCHIP program features the five states have structured to serve these children effectively. The third examines the specialty provider networks for physical and mental health services, and the fourth assesses service coverage and access for these services. The fifth section considers other issues affecting access to care by children with special health care needs, including plan selection, health risk assessments, case management, multidisciplinary care, and cost sharing. The appendix provides a short summary of each state's SCHIP program with details given table formats.

Keywords: Access to health care, California, Children with special health care needs, Connecticut, Maryland, Missouri, Provider networks, Quality assurance, Service delivery, State Children's Health Insurance Program, State initiatives, Utah

McManus MA, Fox HB. 2000. S-CHIP administration and accountability. Washington, DC: Kaiser Commission on Medicaid and the Uninsured, 26 pp.

Annotation: This report examines access to care under the State Children's health Insurance Program (SCHIP). It describes results of a study of SCHIP programs in five states; California, Connecticut, Utah, Maryland, and Missouri. The goal was to understand how program arrangements and plan requirements influence the delivery and quality of care for SCHIP participants and the ease of program implementation for states. The report is divided into three sections. The first addresses how the five SCHIP programs in the study made their basic program design decisions. The second examines how they chose to have their programs administered. The third discusses their experiences related to the administrative challenges of enrollment, premium collection, tracking mechanisms for cost sharing, quality oversight, and complaints and grievances. The appendix provides a short summary of each state's SCHIP program with details given in table formats.

Keywords: Access to health care, California, Connecticut, Maryland, Missouri, Provider networks, Quality assurance, Service delivery, State Children's Health Insurance Program, State initiatives, Utah

Fox HB, McManus MA. 2000. S-CHIP managed care contracting. Washington, DC: Kaiser Commission on Medicaid and the Uninsured, 27 pp.

Annotation: This report examines the design and implementation of managed care contracting under the State Children's Health Insurance Program (SCHIP). The report describes results of a study of SCHIP programs in five states; California, Connecticut, Utah, Maryland, and Missouri. The goal was to understand how program arrangements and plan requirements influence the delivery and quality of care for SCHIP participants and the ease of program implementation for states. This report is divided into three sections. The first addresses the plan selection process used by the five SCHIP programs in the study. The second examines the managed care contract provisions established by the programs regarding provider networks, access, and quality reporting. The third describes each study state's SCHIP capitation rates and the approaches used to establish the rates. The appendix provides a short summary of each state's SCHIP program with details given in table formats.

Keywords: Access to care, California, Connecticut, Managed care, Maryland, Missouri, Provider networks, Quality assurance, Service delivery, State Children's Health Insurance Program, State initiatives, Utah

VanLandeghem K, Sonosky CA, Kagan, J. 1998. Maternal and child health principles in practice: An analysis of select provisions in Medicaid managed care contracts. Washington, DC: Association of Maternal and Child Health Programs and Center for Health Policy Research, 129 pp., exec. summ. (4 pp.).

Annotation: This report examines core issues purchasers should consider in developing state Medicaid managed care contracts. These issues are outreach, enrollment, and information; sound financial structures; standards and guidelines; quality assurance; collecting and reporting data; monitoring and evaluation; assuring appropriate provider networks and accessible settings; assuring access to needed services through service planning and care coordination; and linking resources. [Funded by the Maternal and Child Health Bureau]

Keywords: Access to health care, Contract services, Data collection, Enrollment, Evaluation, Guidelines, Health maintenance organizations, Medicaid managed care, Monitoring, Outreach, Provider networks, Quality assurance, Reports, Standards, State health insurance programs
   

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