Research & Reports
-
Fulfilling the Promise of Children’s Dental Coverage
By Colin Reusch, Senior Policy Analyst with the Children’s Dental Health Project, and Joan Alker, Executive Director of the Center for Children and Families Introduction Fulfilling the Promise of Children’s Dental Coverage is the second brief in our Future of Children’s Health Coverage series. The brief, coauthored by Colin Reusch with the Children’s Dental Health Project,…
-
Medicaid/CHIP Managed Care Regulations: Assuring Quality
While the rules governing Medicaid/CHIP managed care remained unchanged for more than a decade, significant advances have been made in assessing quality, access, and timeliness of care in health coverage programs. During this time, there has been a growing recognition of the need to ensure that the care delivered through capitated managed care arrangements is…
-
Comments on Proposed Changes to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement Programs
Attached are the comments we submitted to CMS on the Medicaid Eligibility Quality Control and Payment Error Rate Measurement Programs rule.
-
The Future of Children’s Health Coverage
(Updated August 2021) The Affordable Care Act, Medicaid and the Children’s Health Insurance Program have made historic progress in reducing the child uninsured rate. Yet some families continue to have difficulty affording coverage and getting their children the care they need. In June of 2016, the Center for Children and Families launched a series of…
-
Medicaid/CHIP Managed Care Regulations: Network Adequacy and Access to Services
Georgetown University Center for Children and Families (CCF) and the National Health Law Program (NHeLP) have teamed up to bring advocates for children and low-income families critical information about the recently finalized Medicaid and CHIP managed care regulations. This paper is the fourth in the series, and it describes how the new rules assure network…
-
Medicaid Expansion Promotes Children’s Development and Family Success by Treating Maternal Depression
This paper examines one important reason why access to Medicaid for poor adults is crucial for children’s healthy development. Other research has documented the reasons why Medicaid coverage matters so much for uninsured adults, both parents and non-parents: It reduces the rate of uninsurance, allows them to get treatment for medical and mental health problems, and stabilizes family finances.…
-
Medicaid/CHIP Managed Care Regulations: Enhancing the Beneficiary Experience
As managed care and particularly mandatory managed care programs have become the predominant model for delivering care in Medicaid, there has been a growing recognition of the need to provide potential enrollees with accurate and timely information about their managed care options, to enable and encourage an active choice of plans, and to ensure that…
-
Medicaid/CHIP Managed Care Regulations: Improving Consumer Information
Over the past decade or so as managed care has become the predominant delivery system in Medicaid and CHIP, there has been a growing recognition of the need for current, accurate, and thorough consumer information to aid potential managed care enrollees in making an informed plan selection and in understanding how to maximize their benefits…
-
Looking at the New Medicaid/CHIP Managed Care Regulations Through a Children’s Lens
In May 2016, the Centers for Medicare & Medicaid Services (CMS) finalized sweeping regulatory changes for managed care in Medicaid and the Children’s Health Insurance Program (CHIP). Almost nine of every 10 children enrolled in Medicaid and CHIP receive health care through a managed care arrangement. This paper examines the impact of Medicaid/CHIP Managed Care…
-
Fact Sheet: Medicaid’s Role for Children
Medicaid is an essential source of health coverage for the nation’s children. The program provides health coverage to children and parents in low-income families who lack access to affordable private health insurance, as well as to children with special health care needs.
-
How Is Florida’s Medicaid Managed Care Working for Children?
How is Florida’s Medicaid managed care working for children? To answer this question, we looked at existing data sources and also conducted a survey of pediatricians in Florida. Our results suggest there is considerable room for improvement in Medicaid managed care for Florida’s children.
-
Beyond the Reduction in Uncompensated Care: Medicaid Expansion Is Having a Positive Impact on Safety Net Hospitals and Clinics
More than two years after the onset of expanded Medicaid coverage, significant differences are emerging between states that opted to expand Medicaid and those that did not. This report contains the findings of telephone interviews with eleven leaders of hospital systems and federally qualified health centers (FQHCs) in seven states. Three of the states where we conducted interviews…
-
The Future of Children’s Health Coverage: Children in the Marketplace
Summary This paper addresses changes needed to improve the ability of Marketplace coverage to meet children’s needs. As the paper notes, relatively few children (approximately one million) receive their coverage through the Marketplace; most in public coverage are served through Medicaid and the Children’s Health Insurance Program. As a new source of coverage, and one…
-
How Does Florida Perform on the Quality of Health Care for Children Enrolled in Medicaid and CHIP?
Since 2011, the U. S. Department of Health and Human Services (HHS) has released an “Annual Report on the Quality of Care for Children in Medicaid and CHIP.” The report includes data submitted by the states on the Child Core Set of Health Care Quality Measures (child core set) and summarizes the results of the…
-
Making Medicaid Work Better: Lessons from States on Implementing Ex Parte Renewals
This brief focuses on states’ experiences in implementing data-driven renewals in Medicaid through a process called ‘ex parte’ – using third party data sources to confirm ongoing eligibility. We interviewed officials in eight diverse states to identify the challenges states face in automating the renewal process and summarize their experiences in overcoming these barriers to…
-
ICHIA Option: Which States Cover Legal Immigrant Children in Medicaid/CHIP?
[Note: This fact sheet was updated in 2018.] The 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) gave states a new option to begin using federal matching dollars to cover lawfully residing children during their first five years in the U.S. This fact sheet provides an overview of this option and details the states that…
-
Measuring and Improving Health Care Quality for Children in Medicaid and CHIP: A Primer for Child Health Stakeholders
A large body of evidence shows that, compared to low-income uninsured children, Medicaid has been highly successful in providing children with a usual source of care and regular well-child care while significantly reducing unmet or delayed needs for medical care, dental care, and prescription drugs due to costs. Nonetheless, quality improvement centers on the notion…
-
Getting Enrollment Right for Immigrant Families
The Affordable Care Act (ACA) has yielded impressive progress in reducing the ranks of the uninsured, with more than 12 million people covered by the health insurance marketplaces alone. However, meeting the goal of enrolling the remaining seven million people who are eligible for marketplace coverage but are still uninsured— even after the third open…
-
Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey
Executive Summary January 2016 marks the end of the second full year of implementation of the Affordable Care Act’s (ACA) key coverage provisions. This 14th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies provides a point-in-time snapshot of policies as of January 2016 and identifies changes in policies that occurred…
-
Historic Gains in Health Coverage for Hispanic Children in the Affordable Care Act’s First Year
The Affordable Care Act has dramatically increased the pace at which the uninsured rate is falling for Hispanic children. Yet Hispanic children are more likely to be uninsured than other children, making them vulnerable to going without health care and leaving their families exposed to financial risk. Given the high rates of uninsurance among Hispanic children, policymakers,…
