Search Results: MCHLine

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 21 through 40 (206 total).

Centers for Medicare & Medicaid Services. 2016. Perinatal care in Medicaid and CHIP. Baltimore, MD: 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.

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]

Link

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.

Link

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.

Link

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.

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.

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.

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.

Link

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.

Link

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

Jee J, Nagarajan J. 2014. Identification and assessment of children and youth with special health care needs in Medicaid managed care: Approaches from three states. Portland, OR: National Academy for State Health Policy, 23 pp.

Annotation: This report describes approaches in three states (California, Michigan, and Minnesota) to identify and assess children and youth with special health care needs (CYSHCN) in Medicaid managed care. Topics include identification and assessment of contract requirements; monitoring and quality improvement; and collaboration between Medicaid, health plans, Title V, and families. The report concludes with a discussion and promising practices for implementing Medicaid managed care for CYSHCN that emerged from the states studied.

Keywords: Adolescents, Children, Collaboration, Contract services, Families, Medicaid managed care, Monitoring, Program improvement, Quality assurance, Special health care needs, Title V programs

Moses K, Klebonis J, Simons D. 2014. Developing health homes for children with serious emotional disturbance: Considerations and opportunities. Hamilton, NJ: Center for Health Care Strategies, 5 pp.

Annotation: This issue brief highlights health home opportunities for children with serious emotional disturbance (SED) and presents considerations to help states develop models that address this population’s unique needs. Topics include identifying the target population; developing provider standards; and defining health home services including care coordination, individual and family supports, and community and social supports. Additional topics include chronicity of illness in children vs. adults and opportunities to provide intensive care coordination, build care management entities, and avoid duplication of services and payment.

Keywords: Adolescents, Affective disorders, Children, Chronic illnesses and disabilities, Medicaid managed care, Service coordination, Special health care needs, State programs, Young adults

Summer L, Hoadley J. 2014. The role of Medicaid managed care in health delivery system innovation. New York, NY: Commonwealth Fund, 23 pp.

Keywords: Access to health care, Barriers, Health care delivery, Health care systems, Medicaid managed care, Program improvement

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.

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

Chazin S. 2014. Medicaid contracting strategies to improve children's oral health care access. Hamilton, NJ: Center for Health Care Strategies, 11 pp. (Technical assistance brief)

Annotation: This brief presents contract-based options for improving access to oral health care for children and adolescents enrolled in Medicaid. It describes how states with managed-care-delivery systems can use contracting mechanisms and incentives to engage plans and health professionals in improving access to children's oral health care oral health outcomes.

Keywords: Access to care, Children, Contract services, Medicaid managed care, Oral health, Program improvement, Service delivery systems, State programs

Yarbrough C, Vujicic M, Nasseh K. 2014. Medicaid market for dental care poised for major growth in many states. Chicago, IL: American Dental Association, Health Policy Institute, 10 pp. (Research brief)

Annotation: This brief provides findings from a study to measure growth in the Medicaid market by comparing the potential increase in the number of adults and children with Medicaid dental benefits to pre-Medicaid expansion levels in select states. Topics include the potential increase due to the Affordable Care Act (ACA) in the number of adults with Medicaid dental benefits by state and the potential increase due to the ACA in the number of adults with Medicaid dental benefits in states where dental benefits are offered as a "value-add" in managed care programs. The brief also examines the potential percentage change in the number of children with Medicaid by state.

Link

Keywords: Adults, Children, Comparative analysis, Dental insurance, Health care reform, Market research, Medicaid, Medicaid managed care, Oral health, Patient Protection and Affordable Care Act, State programs, Statistical data

National Institute for Health Care Management Foundation, American Bar Association Center on Children and the Law. 2013. The health of children in foster care: Making improvements through Medicaid and the law. Washington, DC: National Institute for Health Care Management Foundation,

Annotation: This webinar, held on April 16, 2013, focuses on opportunities to improve the health of children in foster care. Topics include trends in the health of children in foster care, including their unmet needs and disproportionate cost to Medicaid; a review of a successful state and private sector partnership to improve services for the foster population through Medicaid managed care; and laws that promote the health of children and youth who are in or aging out of foster care, including the Affordable Care Act. The web site archives the agenda, speaker biographies, resources, and presentations.

Link

Keywords: Access to health care, Child health, Foster care, Foster children, Health care delivery, Medicaid managed care

Silow-Carroll S, Rodin D. 2013. Forging community partnerships to improve health care: The experience of four Medicaid managed care organizations. New York, NY: Commonwealth Fund, 17 pp.

Annotation: This issue brief explores how four managed care organizations (MCOs) serving vulnerable populations are tackling budget cuts and other challenges and changing the way care is delivered by investing in partnerships and a strong community presence. The brief explores promising strategies, presents early results reported by the plans, and identifies factors that appear to contribute to successful MCO-community partnerships as well as policy options for state Medicaid programs that seek to foster these approaches. The brief also discusses drivers (external and internal) of the MCOs' community-based efforts, challenges, and policy implications.

Keywords: Collaboration, Communities, Health care delivery, High risk groups, Low income groups, Managed care, Medicaid, Programs, Public policy, Underserved communities

Courtot B, Coughlin TA, Lawton E. 2013. Medicaid and CHIP managed care payment methods and spending in 20 states: Final report to the Office of Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. Washington, DC: Urban Institute, 51 pp.

Annotation: This report, which is a companion to the Medicaid and CHIP Risk-Based Managed Care in 20 States report, focuses on 20 states' Medicaid and Children's Health Insurance Program (CHIP) managed care payment methods and spending. The states are Arizona, California, Connecticut, Delaware, Florida, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, and Wisconsin. The report addresses two research questions: (1) how do the 20 states establish capitation rates in their Medicaid and CHIP managed care programs, and how have their approaches to and policies for rate setting changed over the past decade and (2) how does monthly Medicaid spending for four distinct managed care enrollee populations (adults and children, with and without disabilities) vary among the 20 states? The report introduces the issues and presents the study approach, methods, findings, and a discussion.

Link

Keywords: Adults, Arizona, California, Children, Children's Health Insurance Program, Connecticut, Costs, Delaware, Disabilities, Florida, Managed care, Maryland, Massachusetts, Medicaid, Michigan, Minnesota, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Rhode Island, State programs, Tennessee, Texas, Virginia, Wisconsin

Allen KD, Pires SA, Mahadevan R. 2012. Improving outcomes for children in child welfare: A Medicaid managed care toolkit. [Hamilton, NJ]: Center for Health Care Strategies, 49 pp.

Annotation: This toolkit describes the efforts of the nine Medicaid managed care organizations (MCOs) that participated in Improving Outcomes for Children Involved in Child Welfare: A CHCS Quality Improvement Collaborative, designed by the Center for Health Care Strategies (CHCS) and funded by the Annie E. Casey Foundation. The toolkit includes a project overview, an overview and description of the impact of the MCOs' initiatives, and discussions of care coordination and lessons learned.

Keywords: Behavior problems, Child health, Child welfare, Chronic illnesses and disabilities, Collaboration, Ethnic factors, Foster care, Foster children, High risk children, Initiatives, Low income groups, Medicaid managed care, Mental health, Programs, Racial factors

Citizens' Committee for Children of New York. 2012. New York City's children and mental health: Prevalence and gap analysis of treatment slot capacity. New York, NY: Citizens' Committee for Children of New York, 29 pp.

Annotation: This report provides information from a study to assess the gap between the need for mental health treatment slots and the number of treatment slots available for children and adolescents throughout New York City. The report discusses the methodology and presents key findings on child and adolescent mental health needs in the Bronx, Brooklyn, Manhattan, Queens, and Staten Island and key findings on capacity and gap analysis. Appendix G of the report, a PowerPoint presentation, is presented in a separate document.

Keywords: Adolescent mental health, Behavior problems, Child mental health, Health care delivery, Health care systems, Health insurance, Low income groups, Managed care, Medicaid, Mental health problems, New York, Research, Statistical data, Treatment, Uninsured persons

« Previous Page