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AAP Reports
 www.aap.org/advocacy/stgov.htm
The American Academy of Pediatrics believes that the law ought to protect the health and well-being of children just as arduously as pediatricians do. When state legislators assemble, children’s issues deserve the same consideration as other matters.

The AAP Division of State Government Affairs is tasked with providing assistance to AAP state chapters as they advocate for children. The following tools/reports/information are available.

The Center for Health Care Strategies (CHCS)
www.chcs.org/publications3960/publications.htm
CHCS offers resources for designing, purchasing, and monitoring publicly funded managed care.
The following tools/reports/information are available.

  • Assessment Tools
  • Behavioral Health
  • Informed Purchasing Publication Series
  • State Medicaid Agencies
  • CHCS Purchasing Institute
  • Children's Health Care
  • Enrollment/Plan Exits
  • Finance
  • Oral Health
  • Performance Measurement and Quality Assurance
  • Pharmacy
  • State Medicaid/SCHIP Program Design -- General
  • Strategic Uses of Data

    CHCS Selects Health Plan and State Partners to Address Health Care Quality for Racially and Ethnically Diverse Populations in Medicaid Managed Care

    Princeton, NJ -- Though the United States is capable of providing the world's best health care, our medical advances are not enjoyed equally. People of racially and ethnically diverse groups experience more barriers to care, a greater incidence of chronic disease, lower quality of care, and higher mortality than whites. To address the challenges, the Center for Health Care Strategies (CHCS), with funding from The Robert Wood Johnson Foundation and The Commonwealth Fund, has selected 12 Medicaid managed care organizations and 12 state Medicaid agencies to develop and test innovative strategies to improve health care quality for all beneficiaries. The initiative is called Improving Health Care Quality for Racially and Ethnically Diverse Populations.

    Participants in the CHCS Best Clinical and Administrative Practices (BCAP) Workgroup: Improving Health Care Quality for Racially and Ethnically Diverse Populations are Blue Cross of California, HealthFirst, Helix Family Choice, LA Care Health Plan, Medica, Molina Healthcare of Michigan, Monroe Plan for Medical Care, Neighborhood Health Plan of Rhode Island, Network Health, SoonerCare, State of Oregon Office of Medical Assistance Programs, and UPMC Health Plan, Inc.

    States participating in the CHCS Purchasing Institute:     Leveraging Data to Reduce Racial and Ethnic Health Disparities are: District of Columbia, Florida, Indiana, Maryland, Michigan, New Jersey, Nevada, Oklahoma, Oregon, Texas, Virginia, and Washington. For funded project descriptions, visit www.chcs.org/info-url_nocat3961/info-url_nocat_show.htm?doc_id=228164.

    Definitions of Disability: Current Federal Standards and Implications of Reform for Medicaid Coverage
    This Resource Paper examines disability definitions and assesses whether the definition used by Medicaid warrants reexamination. The paper can be accessed at: www.chcs.org/publications3960/publications_show.htm?doc_id=282801

    CHCS Seeds Health Plan Best Practices to Improve Quality of Care
    In an extension of its Best Clinical and Administrative Practices (BCAP) initiative for Medicaid health plans, the Center for Health Care Strategies (CHCS) awarded seed grants to: the Amerigroup Corporation of the Mid-Atlantic (Linthicum, MD), Colorado Access (Denver, CO), Gateway Health Plan (Pittsburgh, PA), and Parkland Community Health Plan (Dallas, TX). Read more about the grants that were funded at: www.chcs.org/info-url3969/info-url_show.htm?doc_id=237218

    Improving Coordination Between School-Based Health Centers and Medicaid Managed Care
    This CHCS funded project provided New Mexico with an opportunity to reexamine the status of its school-based health care system and address the financing, quality, and future viability of these programs. As this report details, the "Salud! Comes to Your School" pilot project presented a unique set of opportunities and challenges. Read more on this project at: www.chcs.org/publications3960/publications_show.htm?doc_id=253394

MCH Policy Research Center Publications
www.mchpolicy.org/publications/special.html
Children with Special Health Care Needs Reports, Titles include:

  • Eligibility, Benefits, and Cost-sharing in Separate SCHIP Programs
  • State SCHIP Requirements and Innovations for Children with Special Health Care Needs
  • Many States Reporting Cost-Cutting Measures for Children´s Mental Health Services
  • Program Cuts Affecting Half of All State Title V Programs for Children with Special Health Care Needs
  • The Strengths and Weaknesses of Private Health Insurance Coverage for Children with Special Health Care Needs
  • Pediatric Provider Capacity for Children with Special Health Care Needs: Results from a National Survey of State Title V Directors
  • Access to Care for S-CHIP Children with Special Health Needs
  • An Analysis of Safeguards for Children with Special Needs in States´ Medicaid Managed Care Contracts, 1999
  • Pediatric Provider Networks for Children with Special Needs in the Current Health Insurance Market: Report from an Expert Work Group
  • An Analysis of States´ CHIP Policies Affecting Children with Special Health Care Needs

More information is available from the MCH Library's knowledge path, Child and Adolescent Health Insurance and Access to Care, at mchlibrary.info/KnowledgePaths/kp_insurance.html.

States' Use of Medicaid Options for Expanding Children's Eligibility
All states use at least one of 13 major options for extending Medicaid eligibility to children who do not meet the criteria for mandatory coverage, and most use at least 7, with the most common being coverage of children in state-subsidized adoptions and children in home- and community-based waiver programs
This report is available on the Policy Center web site at: www.mchpolicy.org/documents/MedicaidEligibilityOptionsFactSheet.pdf

The National Center on Financing for Children with Special Health Care Needs
The National Center on Financing for Children with Special Health Care Needs at the Institute for Child Health Policy, University of Florida has just launched a new Issue Brief Series, Focus on Child Health Policy. The first three briefs in this series have been released and are now available at: cshcnfinance.ichp.ufl.edu/publications.asp

  • Issue Brief 1: Financing and Reimbursement Strategies for Children with Special Health Care Needs: A Series Overview
  • Issue Brief 2: State Strategies for Financing Care for CSHCN: How well do they work?
  • Issue Brief 3: Persistence in Health Status and Health Care Expenditures Among Publicly-Insured Children with Special Health Care Needs
  • Issue Brief 4: Commercial Health Plan Exits and Involuntary Plan Switching Among Children in Medicaid
  • Issue Brief 5: The Role of Reinsurance in Financing Children’s Health Care Part I: Plan Size Effects
  • Issue Brief 6: The Role of Reinsurance in Financing Children’s Health Care Part II: Case Mix Effects

Consumer-Directed Health Plans: Will Patients Get the Care They Need?
From the Commonwealth Fund

Consumer-directed health plans are being promoted as a way to curb rising health care spending. Based on the premise that health care services are over utilized, these plans give consumers financial incentives to reduce the use of "nonessential" care. At the same time, they shift the financial burden of health care to patients through higher cost sharing.

But as Commonwealth Fund President Karen Davis writes in a new special issue of Health Services Research, consumer-directed plans' high deductibles and out-of-pocket costs can prevent patients from receiving necessary and effective care, potentially costing the health care system more in the long run.

In the article and a companion Fund issue brief, www.cmwf.org/programs/insurance/davis_cdhc-hsr_ib_773.pdf Davis says these new plans raise serious concerns, particularly for low-income individuals and those with serious or chronic illnesses. Instead of focusing on consumer financial incentives, better management of patients with high-cost conditions has more potential to both improve quality and lower costs, she argues. Health care leaders and policymakers, Davis says, must promote and reward high-performing health systems, hospitals, and physicians. Read the Press Release.

The entire Fund-supported special issue of Health Services Research focusing on consumer-directed health care is available on the Fund's Web site. www.cmwf.org/programs/insurance/healthservicesresearch_index.a

Medicaid and SCHIP
2005 Medicaid Fact Sheets
The American Academy of Pediatrics, in partnership with the National Association of Children's Hospitals (N.A.C.H.), announced the release and availability of new 2005 state-by-state Medicaid fact sheets, online at: www.aap.org/advocacy/washing/elections/med_factsheet_pub.htm

Evaluation Results for CHCS' Medicaid Managed Care Program
Mathematica Policy Research completed an extensive evaluation of the Medicaid Managed Care Program, an initiative launched by The Robert Wood Johnson Foundation in 1995 and run by CHCS to promote high-quality health services for low-income people especially those with special health care needs. The evaluation provides feedback regarding the program from states, health plans and consumer groups; examines the extent to which the program resulted in tangible change; and assesses its importance to the development of Medicaid managed care. CHCS and Mathematica thank the many Medicaid stakeholders who provided valuable feedback in interviews and surveys.
For more information, visit: www.chcs.org/publications3960/publications_show.htm?doc_id=274527

Annual Survey Tracks State SCHIP Programs and Policies Through Changing Times
The report, based on in-depth telephone interviews with SCHIP directors in 13 states, explores characteristics of SCHIP financing and changes to SCHIP enacted or under consideration in 2004. Topics include eligibility, enrollment procedures, outreach, benefits, cost sharing, reimbursement, and crowd out.The report is available at www.urban.org/url.cfm?ID=311166 or www.urban.org/UploadedPDF/311166_A-68.pdf

Agency for Healthcare Research and Quality Issue Brief Presents Findings on Children's Health Care Experiences Before and After Enrollment in SCHIP
Does SCHIP Benefit All Low-Income Children? describes the impact of the State Children's Health Insurance Program (SCHIP) on health care access and satisfaction in three states with separate, freestanding SCHIP programs.

The issue brief, prepared by the Child Health Insurance Research Initiative, presents findings from a survey of parents of all children and adolescents (ages 1-18) enrolled in SCHIP in Kansas and New York, and of adolescents’ ages 12-18 enrolled in SCHIP in Florida. The survey was administered shortly after the children were enrolled and again one year later. The analyses assessed (1) SCHIP's impact on each of three subgroups of children and adolescents: minorities, those with special health care needs, and the long-term uninsured and (2) differences between vulnerable children and other enrollees. The brief includes information on what was learned, a conclusion, policy implications, study methodology, sources, and related studies of interest. www.ahrq.gov/chiri/chiribrf4/chiribrf4.pdf.

Brief Reviews Impact of Increasing Out-of-Pocket Costs on Medicaid and SCHIP Beneficiaries
The issue brief, prepared by the Kaiser Commission on Medicaid and the Uninsured, explores findings from 13 studies conducted between 2001 and 2005 in seven states (Maryland, Oregon, Rhode Island, Utah, Vermont, Washington, and Wisconsin) that have implemented new or increased existing out-of-pocket requirements. The brief includes information on the impact of premiums on enrollment, the impact of cost sharing on access to care, and the impact of increased premiums and/or cost sharing on providers and state budgets. The brief concludes by discussing the implications of the findings. Click here to access issue brief.

Brief Compares Populations, Coverage, and Structure Of Medicaid and SCHIP
Health Coverage for Low-Income Populations: A Comparison of Medicaid and SCHIP examines the similarities and differences between Medicaid and the State Children's Health Insurance Program (SCHIP) as well as the implications of applying some SCHIP design features to the Medicaid program. The issue brief, produced by the Kaiser Commission on Medicaid and the Uninsured, presents an overview of Medicaid and SCHIP and key differences between the two programs in the areas of financing, benefits, and cost sharing. Click here to access issue brief.

Federal Regulations and Vital Child Developmental Services
According to How Medical Claims Simplification Can Impede Delivery of Child Developmental Services, by George Washington University researchers Anne Markus Ph.D., Sara Rosenbaum J.D., Alexandra Stewart, J.D., and Marisa Cox, M.A., provisions in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that require health insurers and providers to use standardized billing codes for medical claims leave little discretion to individual insurers.

To comply with HIPAA, state Medicaid agencies must eliminate some payment codes that have been tailored to the special needs of Medicaid-enrolled children; this process can lead to reduced coverage for mental health services, early intervention, physical and speech therapy, home care, case management, transportation, and other services not usually provided in private physician practices. The authors say that federal policymakers should consider revising the law so that states can preserve coverage of services targeting children at risk for developmental problems.Click here for the full report.

Kaiser Report Examines Implications of Waiver Activity
A March 2005 report of the Kaiser Commission on Medicaid and the Uninsured examines the policy implications of Medicaid Section 1115 waiver activity that has taken place in recent years. Since January 2001, 17 states have received approval for Section 1115 waivers, including Health Insurance Flexibility and Accountability (HIFA) waivers.

The report finds that, in examining this waiver activity: (1) it is difficult to achieve new coverage through waivers without additional federal financial support; (2) states have made a number of changes to eligibility, enrollment, benefits, premiums and cost sharing through these waivers; (3) waiver flexibility is not necessarily sufficient to prevent other cutbacks to the programs; (4) waivers can increase complexity in state Medicaid programs and add administrative complications; and (5) states must accept "budget neutrality" on the part of the federal government, as is standing policy with Section 1115 waivers.
This report can be found online at: www.kff.org/medicaid/7286.cfm

Study Examines Medicaid Expenditures for Individuals with Intellectual Disabilities/Developmental Disabilities
A recent study completed by Lakin, et al. provided evidence that individuals with intellectual or developmental disabilities fare better than other populations that receive Medicaid benefits. The study provides statistics on Medicaid expenditures for the years 1993-2003, and shows that a higher proportion of expenditures was designated for individuals with ID/DD, when compared to other groups.

The authors conclude that individuals with intellectual and developmental disabilities have disproportionate access to funding and also are favored in community-based access to long-term services and supports.

Charlie Lakin et al., Long-term Service and Support Expenditures for Persons with ID/DD Within the Overall Medicaid Program, Mental Retardation, Feb. 2005, at 65-69. For the full story, visit:www.aamr.org/Reading_Room/pdf/FebTrendsMR.pdf

Improving Children's Health: A Chartbook about the Roles of Medicaid and SCHIP
(Connect for Kids Weekly, 1/26/04)
This Chartbook summarizes numerous recent research findings about children who receive health insurance coverage from either Medicaid or the State Children’s Health Insurance Program (SCHIP), the two primary publicly-funded health insurance programs for low-income children. The findings are drawn from a variety of recent sources, including the Centers for Disease Control and Prevention’s (CDC’s) 2001 National Health Interview Survey.

New Resource Guide - Role of Medicare and Medicaid
The Kaiser Family Foundation released new guides, prepared by Bob Williams and Henry Claypool of Advancing Independence and Jeff Crowley of the Georgetown University Health Policy Institute, that explain the role of Medicare and Medicaid for roughly 20 million children, adults and seniors with disabilities. These guides offer a basic introduction to the Medicare and Medicaid programs, including answers to questions such as:

  • How do people with disabilities apply for coverage under Medicare or Medicaid?
  • What is Medicare's policy for covering durable medical equipment?
  • Where can people with disabilities turn if they need help in applying for Medicaid?
  • How do people with disabilities appeal Medicare coverage decisions?
  • Can a person with a disability who has Medicare and/or Medicaid be employed and still keep their coverage?

The guides are available in PDF and HTML formats at:www.kff.org/medicare/med020705pkg.cfm

New CSHSC Report Highlights Importance of Medicaid and SCHIP for Children
A new report of the Center for Studying Health System Change (CSHSC) and the Robert Wood Johnson Foundation highlights the importance of Medicaid and SCHIP in maintaining health insurance coverage for children from 2001-2003.

The report, "Trends in US Health Insurance Coverage, 2001-2003" examines coverage trends for children and adults, and finds that the proportion of non-elderly (under 65) Americans covered by employer-sponsored health insurance fell from 67% to 63% over this time frame. Among children, employer coverage declined from 63.4% to 59.5%. However, an increase in coverage through Medicaid and SCHIP forestalled a significant increase in the uninsured rate. The proportion of Americans under 65 who lacked health insurance increased slightly over this time frame, from 14.1% to 15%, which was not quite statistically significant. With children 18 and younger, public insurance enrollment increased from 17.6% in 2001 to 24.1% in 2003. Low-income (< 200% of the federal poverty level (FPL)) children benefited most from Medicaid and SCHIP - between 2001 and 2003, the proportion of low-income children enrolled in public insurance grew from 37.9% to 49.3%, representing an increase of almost 5 million children.

This report can be found online at: www.rwjf.org/research/researchdetail.jsp?id=1412&ia=132&gsa=1

Medical Care Use and Costs by Special Health Care Needs Status
This report from the Agency for Healthcare Research and Quality estimates medical care use and costs for children with special health care needs based on data from the 2000 Medical Expenditure Panel Survey. The report provides estimates for demographic characteristics of the child, health care use and expenditures, and burden of the child's health care costs on the family.

This report can be found online at: www.meps.ahrq.gov/papers/rf24/rf24.pdf

Medicaid Prescription Drug Reimbursement: Why the Government Pays Too Much
House Oversight and Investigations Subcommittee of Energy and Commerce, Washington, D.C. This hearing, sponsored by the Committee on Energy and Commerce, focuses on Medicaid's prescription drug reimbursement procedure. To view the video hearing or transcript, click here.

National Association of Advocates Issue Brief September 1998
Ensuring Children's Access to Comprehensive Health Benefits: Effective Arguments for Child Advocates

By Amy Checkoway

"Under Title XXI, the State Children's Health Insurance Program (CHIP), states have been given considerable flexibility to define the scope of benefits available to eligible children. Since states can choose to provide CHIP-eligible children with a spectrum of services -- from access to comprehensive benefits to coverage that is considerably more restrictive -- it is important that policymakers, advocates, service providers and parents speak out in support of children's need for the full range of necessary health care. The purpose of this issue brief is to give advocates supporting information that they can use to encourage their states to offer comprehensive benefit packages."

The Next Generation of Medicaid Managed Care
This Resource Paper outlines the experiences of the Brightwood demonstration project, which was designed to serve members with complex medical and behavioral health needs in Massachusetts. The demonstration clearly indicates the benefits of a comprehensive, preventive care approach, one that places an equal emphasis on physical health, behavioral health, and care coordination for people with chronic health conditions. The paper is available at: http://www.chcs.org/publications3960/publications_show.htm?doc_id=293065&inactive=1

SCHIP Expansions Result in Coverage for Children with Chronic Conditions
A study published in the July 2005 issue of Pediatrics shows that expansions in public insurance coverage under SCHIP have improved coverage for children with chronic conditions. The study notes, however, that some eligible children with chronic conditions remain uninsured and that the impact to care and service use were limited. The authors reviewed data from the National Health Interview Survey, identifying children with chronic conditions and examined changes in a broad array of outcomes for such children who gained eligibility under SCHIP or who were already eligible for coverage under Medicaid, comparing periods before and after program implementation. Changes for these groups were then compared with children in higher income groups, whom SCHIP would not affect. The study found that SCHIP expansions resulted in a 9.8% increase in the proportion of children with chronic conditions reporting public insurance coverage and a 6.4% decrease in the proportion uninsured. Unmet health care need dropped by 8%.
The entire article may be found in the July issue of Pediatrics or online at:
http://pediatrics.aappublications.org/cgi/content/abstract/116/1/e34

State and Federal Funding Formulas for State Child Health Insurance Programs: Coverage Options for Children
 In response to dramatic deficits and declines in federal funding, many states have restricted their children’s health insurance programs by implementing enrollment freezes and/or tightening eligibility criteria or standards for renewing existing coverage. This issue brief presents information about different strategies states are using to address SCHIP enrollment and the potential implications for children and their families. Read more at: http://ichp.ufl.edu/new-from-ichp-l/waitinglist2073104final.pdf

Commercial Plans
The following reports are on recent studies conducted by Mathematica Policy Research, Inc., and the Center for Health Care Policy and Evaluation at United Health Group for the federal Maternal and Child Health Bureau in the U.S. Department of Health and Human Services. These studies investigated utilization and cost patterns among a very large sample of children with special health care needs (CSHCN) enrolled in two commercial managed care plans.

Family Cost-Sharing for CSHCN in Employer-Based Managed Care Plans 1999-2001
Better information on the extent to which families pay for health care provided to their children with special health care needs (CSHCN) would be useful for policymakers, physicians, researchers, program administrators and consumers, especially in light of the growing expectation that employees will share a greater proportion of health care costs than they now do. The full report is available at: http://www.mathematica-mpr.com/publications/PDFs/familycost.pdf

Mental Health Services for CSHCN in Commercial Managed Care, 1999-2001
As one of its national objectives for 2010, the Maternal and Child Health Bureau (MCHB) is striving to ensure that all children with special health care needs have adequate insurance coverage, including coverage for mental health services. Although some studies have examined costs of mental health services provided to children with specific types of emotional disorders, few studies have focused on mental health service use and costs within the larger population of children with special health care needs. Better information on this issue will assist the MCHB in shaping future programs and policies to meet national objectives related to insurance coverage for children with special health care needs and, more generally, to support efforts to establish comprehensive, community-based service systems for all individuals within this population. http://www.mathematica-mpr.com/publications/PDFs/menhlthchil.pdf

Prescription Drugs for CSHCN in Commercial Managed Care: Patterns of Use and Cost, 1999-2001
Rapidly rising pharmaceutical costs have contributed to increases in health expenditures nationwide, but few studies have examined this trend in the population of children with special health care needs. Little information is available on costs for different types of pharmaceuticals, the extent to which families share these costs, and the rates of cost increases over time. Comprehensive data on prescription drug costs for these children also may assist health plans to manage benefit packages efficiently and develop effective care management programs for children with complex chronic health conditions. To begin developing this information, the Maternal and Child Health Bureau (MCHB) asked Mathematica Policy Research (MPR) to analyze claims and administrative data on a sample of children with special health care needs enrolled in two commercial managed care plans in 1999, 2000, and 2001. MPR worked collaboratively with the Center for Health Care Policy and Evaluation (CHCPE) at United Health Group to conduct these analyses.
The full report is available at: http://www.mathematica-mpr.com/publications/PDFs/prescription.pdf

These reports may be of substantial interest to medical directors or quality improvement directors in commercial managed care plans. Under a contract with the federal Maternal and Child Health Bureau, Mathematica can provide technical support to health plans interested in developing a quality improvement project for children with special health care needs. If you know anyone in leadership positions in commercial health plans who would be interested in such an project, ask them to contact Henry T. Ireys, PhD at (202) 554-7536, hireys@mathematica-mpr.com, or Rebecca Nyman at (202) 484-4524, rnyman@mathematica-mpr.com

State and National Reports
Healthcare Cost & Utilization Project (HCUP)
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of health care databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ). HCUP databases bring together the data collection efforts of State data organizations, hospital associations, private data organizations, and the Federal government to create a national information resource of patient-level health care data.www.ahrq.gov/data/hcup/

Preventable Hospitalizations: Window Into Primary and Preventive Care, 2000
This Fact Book examines one critical area of health care quality: potentially preventable hospitalizations, or hospitalizations that may be preventable with high quality primary and preventive care. Higher rates of "preventable hospitalizations" may pinpoint areas in which potential improvements can be made in the quality of the U.S. health care system.

This report presents information on preventable hospitalizations for select chronic and acute conditions, as well as for one birth outcome. The Fact Book first addresses these conditions in a broad, national-level context. It evaluates time trends between 1994 and 2000; variations across regions of the United States; and hospitalizations among priority populations, including children, older Americans, women, low-income, and rural residents. The report then provides detailed statistics for each health condition.

" Health Care in the New Congress: Insiders Look Ahead" 12/10/2004
This briefing, co-sponsored by the Alliance for Health Reform and Kaiser Family Foundation, will answer questions on the future of health care such as: What health care legislation might be possible in the next year? The next two years? On what do Republicans and Democrats agree, and where do wide differences of opinion remain? More information is available at: http://kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1325

" 2004: The Year Ahead in Health on the Hill"
Kaisernetwork.org and CQ's Mary Agnes Carey provide a glimpse of the issues that will shape health policy in 2004, including the uninsured, Medicaid, medical malpractice reform and drug reimportation. Carey also talks with Rep. Jim McDermott (D-Wash.) and Sen. Rick Santorum (R-Penn.), who are at the center of the coming health debates, about their takes on the future of these issues.
www.kaisernetwork.org/healthcast/cq/21jan04

The National Center on Financing for CSHCN has released a report entitled "Health Care Use Patterns and Expenditures of Children with Special Health Care Needs (CSHCN) Using National and State Program-level Data to Inform Decisions about Identification, Financing and Reimbursement."

The purpose of this report is to provide a detailed, user-friendly compendium of available data sources (both national and state-level data are reviewed) that can be used to develop profiles of CSHCN and to analyze their health care use and expenditures. Comparisons between data sources are facilitated by a conceptual framework that details the background and purpose, criteria to identify CSHCN, information related to access and utilization, expenditure data, and features of each data set. Although there are numerous applications of each data set, the goal of the report is to describe how various data sources can best be used to answer questions related to the identification of CSHCN, and to financing and reimbursement strategies that will ensure quality care for these children.

The report was completed as part of a cooperative agreement between the Maternal and Child Health Bureau, (MCHB) and the Institute for Child Health Policy at the University of Florida. For additional information, please contact Donna Hope Wegener, Project Coordinator using the information below.

Donna Hope Wegener
Institute for Child Health Policy
1329 SW 16th Street, 5th Floor, Room 5130
Gainesville, Florida 32608
Phone (352) 265-7220, ext. 86278 | Fax (352) 265-7221, 265-7222
E-mail: dhw@ichp.edu

NCSL Policy Report on Quality in Children’s Health Care
The National Conference of State Legislatures (NCSL) Forum for State Health Policy Leadership has released a policy report entitled “Quality in Children’s Health Care,” specifically focusing on the Medicaid and SCHIP programs. The report examines why quality measurement is important for children in Medicaid and SCHIP, the different dimensions of quality that are measured, as well as the role of state legislatures in this process. The report provides a number of quality measurements that exist for children, such as the Health Plan Employer Data Information Set (HEDIS), the Consumer Assessment of Health Plans (CAHPS) and other existing measurement sets, including the AAP’s SCHIP Evaluation Tool. Federal Medicaid Managed Care regulations require states to have a written quality assessment and improvement strategy, and most states require managed care plans to use HEDIS measures as well as other state-designed measures. The report also provides details of quality measurement tools in place in state non-Medicaid SCHIP programs as of September 2001, examines problems measuring quality for children with special health care needs, and discusses issues surrounding cultural diversity. This report can be found online at: http://www.ncsl.org/programs/health/forum/qualitychildrenhealthcare.htm

State Health Facts Online- Kaiser Family Foundation
This new resource contains the latest state-level data on demographics, health, and health policy, including health coverage, access, financing, categorical health spending, health status, and state legislation. It is organized in categories such as age, poverty level, race, ethnicity, and gender and you can compare data for all states or look up an individual state profile. www.statehealthfacts.kff.org/

For the Online Database on Medicaid Benefits, go to: www.kff.org/medicaidbenefits/

State Fiscal Conditions and Health Coverage: An Update on FY2004 and Beyond
The Kaiser Commission on Medicaid and the Uninsured released three new reports on how states are coping with the fourth year of fiscal stress. The third annual survey of the 50 states reveals a far-reaching impact on health coverage for low-income families at a time when enrollment is increasing due to sluggish economic conditions. For more information click here.

Trends in Health Care Coverage
The percentage of all children under age 18 with private health insurance coverage decreased from 71 percent in 2000 to 66 percent in 2003. During the same time period, the percentage of children with Medicaid increased from 20 percent to 26 percent.

Read more at: www.childtrendsdatabank.org/pdf/26_PDF.pdf

Telemedicine
Telemedicine for CSHCN: A State-by-State Comparison of Medicaid Reimbursement Policies and Title V Activities.
 This technical report provides data on a nationwide survey with Medicaid and Title V programs in each of the 50 states regarding telemedicine services, with a specific target of identifying common strategies related to Medicaid reimbursement and the types of telemedicine services specifically available for CSHCN served by Title V. Click here to view the technical report.

Last Updated August 21, 2008
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