Improving Systems
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Boosting Developmental Screening Efforts in Pennsylvania
By Joan Benso, President and CEO, Pennsylvania Partnerships for Children A child’s first years of life are marked by tremendous physical, cognitive, social and emotional growth. Detecting possible delays in development during these early years is a critical part of ensuring every child gets to the best possible start and is well prepared to learn…
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Quality Provisions of the Medicaid/CHIP Managed Care Rules
Thanks to a grant from the Robert Wood Johnson Foundation, CCF has teamed up with NHeLP to launch a series of explainer briefs that unpack the new Medicaid/Children’s Health Insurance Program (CHIP) managed care regulations. Three briefs in the series have been released already: Looking at the New Medicaid/CHIP Managed Care Regulations Through a Children’s Lens, Medicaid/CHIP…
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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…
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How the New Medicaid/CHIP Managed Care Regulations Seek to Improve Network Adequacy and Access to Services
Thanks to a grant from the Robert Wood Johnson Foundation, CCF has teamed up with NHeLP to launch a series of explainer briefs that unpack the new Medicaid/CHIP managed care regulations. Three briefs in the series have been released already: Looking at the New Medicaid/CHIP Managed Care Regulations Through a Children’s Lens, Medicaid/CHIP Managed Care…
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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…
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How the New Medicaid/CHIP Managed Care Regulations Improve Consumer Information
As my colleague, Kelly Whitener, announced last week, thanks to a grant from the Robert Wood Johnson Foundation, CCF has teamed with NHeLP to launch a series of explainer briefs to unpack the new Medicaid/CHIP managed care regulations. The first brief, Looking at the New Medicaid/CHIP Regulations Through a Children’s Lens, was published last week.…
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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…
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Florida’s Medicaid Managed Care Program Has Considerable Room for Improvement
I’m here in Sarasota, Florida today to release our new study looking at the quality of care for the approximately two million kids receiving health care services through Florida’s Medicaid managed care program. The study was commissioned by the Sarasota Herald-Tribune and supported by the Community Foundation of Sarasota County. We appreciate their wonderful partnership on…
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Recent Changes to the Free Care Rule Put Federal Funds Back on the Table
The so-called “Free Care Rule” prevented states from receiving federal Medicaid funds to provide any service that is ordinarily provided for free to the community at large, even if Medicaid would cover these services for its beneficiaries. For instance, if a public school nurse were to examine a student, federal funds could not be used…
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Major New Rule Seeks to Modernize & Improve Quality of Medicaid Managed Care
Earlier this week, CMS released the much-anticipated final rule on Medicaid and CHIP managed care. The rule marks the first update to Medicaid managed care rules in over a decade, and it comes at a time when more and more Medicaid beneficiaries are covered under managed care arrangements. Three-quarters of children, and virtually all adults…
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CMS Releases Final Managed Care Rule for Medicaid, CHIP
Many children and families rely on Medicaid or CHIP as their source of health care coverage and a growing number of them are connecting with that coverage through managed care plans. How managed care is delivered has a significant impact on the health and well-being of children and families. In fact, three-quarters of children enrolled in…
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HHS Study Shows Benefits of Shopping and Subsidies, but Costs Still a Concern
By Sean Miskell As insurers selling on the Affordable Care Act’s (ACA) Marketplaces begin to file their 2017 rates with the Department of Health and Human Services (HHS), concerns over proposed increases will once again emerge. But a report released by the HHS Assistant Secretary for Planning and Evaluation (ASPE) demonstrates that behind the headlines…
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New Brief Highlights States’ Experiences in Implementing Ex Parte Renewals in Medicaid and CHIP
Eligible children and families losing Medicaid or CHIP coverage at renewal for procedural or paperwork reasons has been a persistent problem. As Harvard researcher Dr. Benjamin Sommers has aptly noted, poor retention rather than poor take-up is the main reason why millions of children eligible for Medicaid and CHIP are uninsured. Dr. Sommers’ research has…
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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…
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How Cuts to Safety Net Hospitals Impact the Uninsured in a State that Rejected Medicaid Expansion Funding
by Miriam Harmatz, Florida Legal Services Much has been written—from blogs to briefs—documenting the tremendous positive impacts of Medicaid expansion. Less well-documented are the negative impacts that flow from rejecting expansion. Obviously, non-expansion states fail to reap the profound benefits of expansion. But they are not just failing to move forward with the expansion’s huge…
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It’s Time to Shed More Light on State Medicaid Quality
by Jon Peacock and Sashi Gregory, Wisconsin Council on Children and Families Last week was Sunshine Week, the annual nationwide celebration of access to public information. Now that the celebrating is over, perhaps it’s a good time to bring up an area where Wisconsin needs to let in considerably more sunshine – health care quality measures…
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A Primer on Health Care Quality Measurement and Improvement for Children in Medicaid and CHIP
When I was the CHIP Director in New Hampshire, we thought that achieving a 95% rate of coverage for kids was the high bar. As a country, we are not only closing in on that goal, but leading states have raised the bar to 98% and beyond. And while we must continue to eliminate disparities…
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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…
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Improving Health Care Access for American Indians and Alaska Natives
by Jesse Cross-Call, originally posted on cbpp.org An updated policy for how the federal government helps finance the costs of Medicaid services for American Indians and Alaska Natives will improve the delivery of care and save states money. Medicaid plays a critical role in providing health care to American Indians and Alaska Natives; a quarter…
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Why is North Carolina Getting Rid of Medicaid Managed Care Plan that Saves State Money?
Policymakers in many states have turned more and more to private managed care insurers to manage their Medicaid programs. More than half of people on Medicaid across the country are in some sort of “risk-based managed care organizations (MCOs)” and 39 states – according to comprehensive research by the Kaiser Family Foundation – use such…
