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Strengthen 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 (36 total).

Manz MC. 2016. Methods in assessing non-traumatic dental care in emergency departments. Reno, NV: Association of State and Territorial Dental Directors, 42 pp.

Annotation: This report presents findings from a review of studies on the use of emergency departments for nontraumatic oral health conditions and oral health care. The report discusses variations in target populations, outcomes of interest, predictive factors, data sources, and research methods. Recommendations for future research are included.

Contact: Association of State and Territorial Dental Directors, 3858 Cashill Boulevard, Reno, NV 89509, Telephone: (775) 626-5008 Fax: (775) 626-9268 E-mail: [email protected] Web Site: https://www.astdd.org Available from the website.

Keywords: Dental care, Emergency room data, Health care utilization, Hospital emergency services, Oral health, Research methodology, Utilization review

U.S. Department of Health and Human Services, Office of Inspector General. 2016. Most children with Medicaid in four states are not receiving required dental services. Washington, DC: U.S. Department of Health and Human Services, Office of Inspector General, 29 pp.

Annotation: This report describes the extent to which children enrolled in Medicaid in four states (California, Indiana, Louisiana, and Maryland) received pediatric oral health services in 2011 and 2012. The report also describes barriers and strategies to increase access in these states. Contents include background, methodology, findings, recommendations, and conclusions. Topics include the percentage of children who did not receive required oral health services and percentage of those who did not receive all required oral health services, policies that may limit children's ability to receive required services, shortages of dentists who participate in Medicaid, and challenges in educating families about the importance of oral health care.

Contact: U.S. Department of Health and Human Services, Office of Inspector General, c/o U.S. Department of Health and Human Services, Office of Public Affairs, Cohen Building, Room 5541, 330 Independence Avenue, S.W., Washington, DC 20201, Telephone: (202) 619-1343 Fax: (202) 260-8512 E-mail: [email protected] Web Site: https://oig.hhs.gov Available from the website. Document Number: OEI-02-14-00490.

Keywords: Access to health care, Barriers, California, Children, Dental care, EPSDT, Health care utilization, Health services delivery, Indiana, Louisiana, Maryland, Medicaid, Oral health, Parent education, Policy development, State programs, Utilization review, Work force

Centers for Medicare & Medicaid Services. 2016. Perinatal care in Medicaid and CHIP. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, [52 pp.].

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', 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, s Health Insurance Program

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: [email protected] 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

Clary A, Wirth B. 2015. State strategies for defining medical necessity for children and youth with special health care needs. Portland, ME: National Academy for State Health Policy, 8 pp.

Annotation: This brief explores issues affecting state Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) and Children's Health Insurance Program officials who implement medical necessity policy, and new and emerging issues that may affect state EPSDT policy in the future. Topics include determining medical necessity, setting parameters for medical necessity, using evidence to define medical necessity, and managing medical necessity and managed care.

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.

Keywords: Access to health care, Barriers, Children, Children', EPSDT, Medicaid managed care, Needs assessment, Policy development, Special health care needs, State legislation, Utilization review, s Health Insurance Program

Nasseh K, Vujicic M. 2015. Dental care utilization rate continues to increase among children, holds steady among working-age adults and the elderly. Chicago, II: American Dental Association, Health Policy Institute, 11 pp.

Annotation: This brief presents key findings on patterns of oral-health-care use among children and adolescents ages 2–18, adults ages 19–64, and adults ages 65 and older for the period 2000–2013. Contents include data and methods, results, and discussion. Topics include the percentage of the population with a dental visit by year, age, income, and dental insurance status.

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.

Keywords: Adults, Age factors, Children, Dental care, Dental insurance, Health care disparities, Health care utilization, Low income groups, Older adults, Oral health, Statistical data, Trends, Utilization review

U.S. Government Accountability Office. 2014. Foster children: Additional federal guidance could help states better plan for oversight of psychotropic medications administered by managed care plans. Washington, DC: U.S. Government Accountability Office, 48 pp.

Annotation: This report updates the December 2011 report published by the U.S. Government Accountability Office on foster children in selected states that were prescribed psychotropic medications at rates higher than nonfoster children in Medicaid in 2008. The current report examines instances of foster children being prescribed psychotropic medications in the following five states: Florida, Massachusetts, Michigan, Oregon, and Texas. The report assesses the extent that documentation supported the use of psychotropic medications, describes states' policies related to psychotropic medication, and assesses the U.S. Department of Health and Human Services' actions since GAO's 2011 report.

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-14-362.

Keywords: Drugs, Federal initiatives, Florida, Foster children, Massachusetts, Medicaid managed care, Mental health services, Michigan, Oregon, Policy analysis, State programs, Texas, Utilization review

U.S. Government Accountability Office. 2014. VA spina bifida program: Outreach to key stakeholders and written guidance for claims audit follow-up activities needed. Washington, DC: U.S. Government Accountability Office, 27 pp.

Annotation: This report presenting findings from an evaluation of the administration of spina bifida health care benefits for children of servicemembers and veterans by the U.S. Department of Veterans Affairs' Veterans Health Administration (VHA). Topics include the extent to which VHA conducts outreach about available benefits, what is known about available processed health care claims, and what oversight VHA conducts of the claims process. Recommendations for executive action are included.

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-14-564.

Keywords: Access to health care, Administration, Children with special health care needs, Employee benefits, Federal programs, Health care utilization, Military, Outreach, Spina bifida, Utilization review

Forsberg VC, Peters R, Napoles AI, Shah A, Ramos C, Devers K. 2014. Environmental scan and literature review: Factors that influence preventive service utilization among children covered by Medicaid and CHIP–Improving quality of care in Medicaid and CHIP through increased access to preventive services. Washington, DC: Urban Institute, 56 pp.

Annotation: This document summarizes preventive service use patterns and barriers among infants, children, and adolescents enrolled in Medicaid and the Children's Health Insurance Program, documented cost and health outcomes associated with prevention, and activities and efforts designed to improve preventive service rates and outcomes. Activities are organized according to their target (state, Medicaid/CHIP, providers and delivery systems, or patients). A companion review focuses on the use of preventive services by adults enrolled in Medicaid.

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: Adolescents, Barriers, Children, Children', Costs, Health care utilization, Infants, Literature reviews, Medicaid, Preventive health services, Program improvement, Quality assurance, State programs, Trends, s Health Insurance Program

Ramos C, Spencer AC, Shah A, Palmer A, Forsberg VC, Devers K. 2014. Environmental scan and literature review: Factors that influence preventive service utilization among adults covered by Medicaid–Improving quality of care in Medicaid and CHIP through increased access to preventive services. Washington, DC: Urban Institute, 55 pp.

Annotation: This document summarizes preventive service use patterns and barriers among adults enrolled in Medicaid in order to identify potential opportunities and strategies to promote preventive service use. It explores the influence of a variety of factors that affect the use of preventive services including policy decisions at the federal and state levels, and barriers and facilitators at the delivery system, provider, and patient levels, and how these factors potentially influence use. Evidence around health and costs associated with preventive services use is also summarized. A companion review focuses on the use of preventive services by infants, children, and adolescents enrolled in Medicaid and the Children's Health Insurance Program.

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: Adults, Barriers, Children', Costs, Health care utilization, Literature reviews, Medicaid, Preventive health services, Program improvement, Quality assurance, State programs, Trends, s Health Insurance Program

Park MJ, Brindis CD, Vaughn B, Barry M, Guzman L, Berger A . 2013. Health care services. [Bethesda, MD]: Child Trends; San Francisco, CA: National Adolescent and Young Adult Health Information Center, 10 pp. (Adolescent health highlight)

Annotation: This report presents a research-based case for why adolescents need health services. Contents include recommendations from leading medical authorities on what specific health services adolescents need and how these services can best be provided. Data on the proportion of adolescents currently receiving needed services and an examination of the barriers preventing some adolescents from obtaining services are also included.

Contact: Child Trends , 7315 Wisconsin Avenue, Suite 1200 W, Bethesda, MD 20814, Telephone: (240) 223-9200 E-mail: Web Site: http://www.childtrends.org Available from the website. Document Number: Pub. no. 2013-10.

Keywords: Access to health care, Adolescent health services, Barriers, Needs assessment, Utilization review

Bethell C, Gombojav N, Stumbo S, Brown C, Blumberg S, Carle A, Newacheck PW. 2013. Using the National Health Interview Survey and Medical Expenditure Panel Survey to assess the use and impact of complementary and alternative medicine among children in the United States: A meta-data methods key issues report. Portland, OR: Data Resource Center for Child and Adolescent Health, 29 pp.

Annotation: This report describes key methodological aspects and issues to consider when using the 2007 National Health Interview Survey (NHIS) data files and the linked file of the 2007 NHIS and the 2008 Medical Expenditure Panel Survey to evaluate use and impact of complementary and alternative medicine among children in the United States. Topics include weighting, sample size and limits of the linked data sets, validity evaluation, and variable construction using currently available population-based data files. [Funded by the Maternal and Child Health Bureau]

Contact: Data Resource Center for Child and Adolescent Health, Child and Adolescent Health Measurement Initiative, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, E-mail: [email protected] Web Site: https://childhealthdata.org Available from the website.

Keywords: Alternative medicine, Child health, Data, National surveys, Research methodology, Treatment effectiveness evaluation, Utilization review

U.S. Centers for Medicare & Medicaid Services. 2010. State of Arizona Medicaid dental review. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 7 pp.

Annotation: This report summarizes a review of Arizona’s Medicaid dental program conducted on January 11–15, 2010, to identify practices and program innovations leading to a higher level of oral-health-service use among children in Arizona compared to the national average. The report describes state-level accountability, managed care organization performance transparency, the establishment of a state Medicaid dental director position, and the Special Needs Dental Clinic.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Arizona, Children, Dental care, EPSDT, Oral health, State surveys, Utilization review, children

U.S. Centers for Medicare & Medicaid Services. 2010. State of Maryland Medicaid dental program review. [Baltimore, MD]: U.S. Centers for Medicare & Medicaid Services, 11 pp.

Annotation: This report summarizes a review of Maryland’s Medicaid dental program conducted on March 17–26, 2010, to identify practices and program innovations leading to a higher level of oral-health-service use among children in Maryland compared to the national average. The report describes an increase in reimbursement rates; the establishment of a single contractor to administer oral health services for children; payment to Early and Periodic Screening, Diagnostic, and Treatment Program (EPSDT)-trained providers for applying fluoride varnish to the teeth of infants and young children ages 9 to 36 months; involvement, leadership, and support of key stakeholders; the loan-assistance program to increase the number of dentists participating in Medicaid; and other public health initiatives.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Children, Dental care, EPSDT, Maryland, Oral health, State surveys, Utilization review

U.S. Centers for Medicare & Medicaid Services. 2010. State of North Carolina Medicaid dental review. [Baltimore, MD]: U.S. Centers for Medicare & Medicaid Services, 8 pp.

Annotation: This report summarizes a review of North Carolina's Medicaid dental program conducted on February 22-26, 2010, to identify practices and program innovations leading to a higher level of oral health service use among children in North Carolina compared to the national average. The report describes the Task Force on Dental Care for Children, the Into the Mouths of Babes program, the North Carolina Dental Home Initiative, the Zero Out All Early Childhood Tooth Decay project, safety net dental clinics, and the loan repayment program.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Children, Dental care, EPSDT, North Carolina, Oral health, State surveys, Utilization review

U.S. Centers for Medicare & Medicaid Services. 2010. State of Nebraska Medicaid dental review. [Baltimore, MD]: U.S. Centers for Medicare & Medicaid Services, 6 pp.

Annotation: This report summarizes a review of Nebraska’s Medicaid dental program conducted during the week of January 18, 2010, to identify practices and program innovations leading to a higher level of oral-health-service use among children in Nebraska compared to the national average. The report describes initiatives to serve children from families with low incomes and increase the number of providers in underserved areas, efforts to enlist the help of dentists on local health department boards and public health nurses for missed appointment follow-up, and consultation between the state department of health and the state dental association to implement rate increases targeting specific recommended procedure codes.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Children, Dental care, EPSDT, Nebraska, Oral health, State surveys, Utilization review

U.S. Centers for Medicare & Medicaid Services. 2010. State of Rhode Island Medicaid dental review. [Baltimore, MD]: U.S. Centers for Medicare & Medicaid Services, 8 pp.

Annotation: This report summarizes a review of Rhode Island's Medicaid dental program conducted on November 30 to December 4, 2009, to identify practices and program innovations leading to a higher level of oral health service use among children in Rhode Island compared to the national average. The report describes the Medical Dental Advisory Committee, the RIte Smiles dental program, and affiliation with Head Start programs.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Children, Dental care, EPSDT, Head Start, Oral health, Rhode Island, State surveys, Utilization review

U.S. Centers for Medicare & Medicaid Services. 2010. State of Texas Medicaid dental review. [Baltimore, MD]: U.S. Centers for Medicare & Medicaid Services, 10 pp.

Annotation: This report summarizes a review of Texas' Medicaid dental program conducted on November 30 to December 4, 2009, to identify practices and program innovations leading to a higher level of oral health service use among children in Texas compared to the national average. The report describes efforts to increase reimbursement rates, a legislatively-supported initiative to provide preventive oral health care in the early months of life, a strategy to encourage pediatric primary care health professionals to provide oral health care in the medical home, a loan repayment program for dentists and physicians who treat Medicaid beneficiaries, and meetings to promote stakeholder ownership in the state's oral health program.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Children, Dental care, EPSDT, Oral health, State surveys, Texas, Utilization review

U.S. Centers for Medicare & Medicaid Services. 2010. Commonwealth of Virginia Medicaid dental program review. [Baltimore, MD]: U.S. Centers for Medicare & Medicaid Services, 7 pp.

Annotation: This report summarizes a review of Virginia’s Medicaid dental program conducted on January 25 to February 1, 2010, to identify practices and program innovations leading to a higher level of oral-health-service use among children in Virginia compared to the national average. The report describes efforts to increase provider reimbursement rates; establish a single contractor to administer Smiles for Children; enhance support from the state governor, legislature, dental association, and medical director and other stakeholder initiatives; and increase the number of participating dentists.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Children, Dental care, EPSDT, Oral health, State surveys, Utilization review, Virginia

U.S. Centers for Medicare & Medicaid Services. 2010. State of Alabama Medicaid dental review. [Baltimore, MD: U.S. Centers for Medicare & Medicaid Services], 8 pp.

Annotation: This report summarizes a review of Alabama's Medicaid dental program conducted on January 4-8, 2010, to discover practices and program innovations leading to a higher level of oral health service use among children in Alabama compared to the national average. The report describes the Smile Alabama initiative, the 1st Look program, Student/Resident Rotations in Community Health (SEARCH), the partnership with the University of Alabama School of Dentistry, and the loan repayment program.

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Alabama, Children, Dental care, EPSDT, Oral health, State initiatives, State surveys, 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.