Achieving
Service Integration for Children with Special Health Care Needs: An
Assessment of Alternative Medicaid Managed Care Models: Volumes 1 and
2
Vol. 1 (149 kb file)
Vol. 2 (564 kb file)
To gain
a more complete understanding of the effects of managed care on service
delivery for CSHCN, the National Policy Center for Children with Special
Health Care Needs studies eight States with different Medicaid managed
care models and, using qualitative evaluation methods, examined the
extent to which the alternative models supported effective, cross-system
service integration for CSHCN. This report presents the results of this
analysis. Volume 1 is a synthesis of study results and Volume 2 contains
the case studies. (Prepared for MCHB, July 1999)
Understanding the Alphabet Soup of Managed Care Integrated Delivery
Systems (Workshop Summary)
This summary
covers a workshop held in Philadelphia in October 1998 which addressed
the information needs of State and local policymakers and program administrators
who have responsibility for providing oversight of and contracting with
integrated health care delivery systems. (Prepared for AHRQ, 1998)
TIE Communique on Monitoring Treatment Outcomes and Managed Care: Promise
and Challenge for AOD Field
339 kb file
In
this document, expert writers who are policymakers, providers, researchers,
clinicians, and State and county personnel address the transition of
State Alcohol and Drug Abuse Agencies to managed care. (Prepared for
CSAT Division of State and Community Assistance, Fall 1998) 339KB PDF
downloadable.
Worker Compensation and Managed Care: Challenges
and Opportunities in a Changing Health Care System (Workshop Summary)
This document
covers a Chicago 1997 workshop that drew upon available health services
research and the experiences of individual States to provide participants
with a better understanding of the current issues, opportunities, and
challenges of adopting managed care models and practices in workers'
compensation medical programs. (Prepared for AHRQ, 1997)
Managed
Care and Children with Special Health Care Needs: Strategies for Monitoring
the Quality of Care
160
kb file
To assist
the Children and Youth Section of the North Carolina Division of Maternal
and Child Health, HSR reviewed the state of the art in the development
of measurement tools and quality indicators for this population. This
report presents sample indicators and recommendations for monitoring
the structure, process, and outcome of their care. (Prepared for North
Carolina Department of Environment, Health, and Natural Resources, March
1997)
Assessing Roles, Responsibilities, and Activities in a Managed Care
Environment - A Workbook for Local Health Officials
This document
provides an overview of efforts by the AHRQ User Liaison Program and
a public health work group comprised of representatives from the National
Association of County and City Health Officials (NACCHO), the Association
of State and Territorial Health Officials (ASTHO), and the Association
of Maternal and Child Health Programs (AMCHP) to help local Health Department
officials identify effective ways to carry out their core function responsibilities
in the managed care environment. (Prepared for AHRQ, 1996)
Practice Guidelines and Standards of Care for Children with Special
Health Care Needs: Report and Compendium
69 kb file
For the
State of North Carolina, HSR collected and compiled guidelines for the
ten most common and costly conditions affecting CSHCN in North Carolina:
asthma, ADHD, cerebral palsy, congenital deafness, cystic fibrosis,
diabetes, sickle cell disease, spina bifida, epilepsy, and mild mental
retardation. The report is designed to assist the state in developing
a set of standards to apply to the care of CSHCN in managed care settings.
An overview chapter of the compendium summarizes the guidelines that
were identified and the processes by which they were developed. (Prepared
for North Carolina Department of Environment, Health, and Natural Resources,
1996)
Critical
Issues in Designing Contracts for Managed Care Organizations Serving
Children with Special Health Care Needs
187 kb file
This report
analyzes and identifies critical policy issues for State officials to
address in contracting with managed care entities to serve CSHCN and
provides model language from other States that hold promise for safeguarding
the health of CSHCN by addressing such concerns as identification of
CSHCN, referrals, access and availability requirements, provider networks,
benefit coverage, links to outside systems, financing, and quality monitoring.
(Prepared for Maryland Department of Health and Mental Hygiene, October
1996)
Integrating Case Management Services in a Managed Care Environment
209 kb file
This project
final report includes a proposal for the State of Texas to improve standardization
across case management programs and recommendations for ensuring that
individuals being served through both primary care case management and
risk-based managed care arrangements receive levels of case management
appropriate to their needs. (Prepared for Bureau of Women and Children,
Texas Department of Health, 1996)
Adapting MCH Systems in a Changing Health Care Environment: Summary
of Technical Assistance Provided to the State of Nebraska
140 kb file
For the
State of Nebraska, HSR provided technical assistance on broad range
of issues surrounding evolving roles for Title V in a changing health
care environment. The final project report includes an analysis of Nebraska's
evolving state health care system, as well as summaries of two workshops
conducted for Nebraska officials on such topics as maternal and child
health systems development and providing high quality care to children
with special health care needs enrolled in Medicaid managed care arrangements.
(Prepared for Nebraska Department of Health, 1996)
Delivering
and Financing Services for Vulnerable Children Under Health Care Reform
211 kb file
For the
State of Minnesota, HSR and its consultant analyzed alternative service
delivery and payment options for "wrap-around" services for
four populations of vulnerable children under the State's health care
reform initiative: children with special health care needs, children
at psychosocial risk of poor growth and development, adolescents, and
low-income children who face barriers to accessing health services.
(Prepared for Minnesota Department of Health, November 1995)
Assessing the Risk of Women and Children Enrolled in Managed Care: Design
Options for South Carolina Officials
60 kb file
For the
State of South Carolina, HSR analyzed how 13 States are designing and
implementing risk assessment systems under Medicaid managed care for
three populations of critical concern: pregnant women, children with
special health care needs, and children with mental health needs. (Prepared
for the South Carolina Department of Health and Environmental Control,
August 1995)
Coordinating Adolescent Health Centers and Managed Care: State Experiences
and Lessons Learned
131 kb file
For the
State of Michigan, HSR analyzed 13 States' policies and systems designs
for coordinating Medicaid managed care plans and school-based health
centers. The report describes the implementation of contracts between
school-based clinics and managed care plans, discusses the types of
efforts that State agencies have undertaken to encourage the development
of these contracts, and summarizes the lessons learned in the 13 States
regarding successful coordination between school-based health centers
and managed care organizations. (Prepared for Michigan Department of
Public Health, November 1995)
Improving the Quality and Coordination of Care for Indiana's Children
with Special Health Care Needs
242 kb file
This report
includes two proposals: the first presents strategies for developing
a Medicaid-financed care coordination system for CSHCN, and the second
presents both quality standards for CSHCN served under risk-based managed
care arrangements, as well as a draft Medicaid and public health interagency
agreement outlining possible public health roles under primary care
case management arrangements. (Prepared for The Indiana State Department
of Health, October 1994)
Monitoring
the Impact of Managed Care on Mothers and Children in Seattle/King County
196 kb file
For Washington
State, HSR and the Health Policy Analysis Program at the University
of Washington (HPAP) designed a system to measure the impact of managed
care on public health clients, providers, and systems. Using a baseline
set of health and system indicators collected by HPAP, the report outlines
a data system that program managers, plan administrators and policy
makers can use to monitor changes in access and quality in King County's
Medicaid managed care program over time. (Prepared for Washington State
Department of Health, 1994)
