While college basketball players waited to hear the team matchups for the National Collegiate Athletic Association (NCAA) tournament known as March Madness, medical students anxiously awaited a different kind of match. March 15 was Match Day, the day graduating medical students find out where they will spend their residency training. New medical schools, coupled with more schools graduating larger classes made this a record year for the number of matches. This was also a record year for the number of graduates who chose residencies in pediatrics and family practices - both primary care fields.  The National Resident Matching Program reports 105 more matches in pediatrics and 33 more matches in family practice than last year. This is encouraging news. There is a concern that there will be a shortage of primary care providers once the Affordable Care Act (ACA) is fully implemented and more people access primary care because they are newly eligible for Medicaid or other health insurance.  

The use of premium assistance - public funds from Medicaid and the Children's Health Insurance Program (CHIP) to purchase employer-sponsored insurance (ESI) for parents whose children are enrolled in Medicaid and CHIP - is a win-win for states and for families. States keep the majority of their health insurance costs in the private sector and reduce uninsurance among parents who are not eligible for Medicaid. Parents receive assistance to pay for their share of ESI premiums, and Medicaid and CHIP provide wrap-around services and pick up the difference between what the ESI pays and a family's out-of-pocket costs for their children's health services. This brief provides an overview of the requirements for premium-assistance programs and new options available through the Children's Health Insurance Program Reauthorization Act (CHIPRA) and the Affordable Care Act (ACA). In order to provide premium assistance, states must prove that providing it is cost neutral or less expensive than enrolling individuals in Medicaid or CHIP. Employers will provide descriptions of their ESI plan to make it easier for states to determine the cost-effectiveness of premium assistance. However, states report this is increasingly difficult to do, as fewer employers offer ESI, employees are paying higher premiums and cost-sharing for services, and the increased use of high-deductible plans make comparison with Medicaid difficult. In states that opt to implement the Medicaid expansion for adults up to 133% of the federal poverty level, more parents will be eligible for Medicaid. In expansion states, it may be cost-effective to provide premium assistance to help families afford their ESI option. In families where parents have an Exchange plan and children have CHIP, premium assistance may make it possible for the entire family to be covered under a single plan, while maintaining CHIP benefits and cost sharing. To reduce churn due to income changes, some states are exploring the option of using premium assistance to purchase exchange plans for adults newly eligible for Medicaid, rather than enroll them in Medicaid.    

Norwood and Slayton provide an overview of the oral health needs of children with developmental disabilities, discuss the barriers to care, and suggest ways pediatricians can help bridge the gap in unmet dental care needs. Barriers to care include uninsurance, underinsurance, and inability to find a dentist due to a shortage of providers. Even when families can identify a dentist, the provider may not have the education and training to treat a child with medical and/or behavioral issues. The authors note that the Medicaid program in 40 states reimburses medical providers for oral screenings and for the application of dental varnish. They encourage pediatricians to make dental varnish "a high priority for children with developmental disabilities." They also suggest that pediatricians use an Oral Health Risk Assessment Tool to help assess a child's risk of dental caries and to guide decisions about appropriate dental referrals, develop partnerships with dental providers who will treat children with developmental disabilities, encourage the development of good oral hygiene habits, and advocate for oral health care for children with developmental disabilities.  

Since 1990, the U.S. Department of Health and Human Services (HHS) has issued Healthy People objectives for improving the health of all Americans. Healthy People 2020 includes almost 600 objectives in topic areas ranging from A (access to health care) to V (vision). The Genetic Alliance, Family Voices, and the Maternal and Child Health Bureau (MCHB) selected 46 objectives that have the potential to influence the life course of children and youth with special health care needs (CYSHCN) and examined them within the context of the MCHB's six performance outcomes for CYSHCN. Read their findings, documented with both data sources and family stories, in Children and Youth with Special Healthcare Needs in Healthy People 2020: A CONSUMER PERSPECTIVE .

Join the National Center for Medical Home Implementation (NCMHI) and the National Center for Cultural Competence to learn about best practices for providing culturally and linguistically competent health care to an increasingly diverse patient population. This is the second in a free, four-part Medical Home in Pediatrics How To webinar series hosted by the American Academy of Pediatrics (AAP) and NCMHI. These learning sessions are for pediatric providers, patient and family advocates, health policy administrators, and others interested in advancing the medical home model for children. Register for this webinar. Review the 2013 webinar series schedule and the archive of the first webinar, How to Engage Youth in their Health Care. 

Transition? Radio Episode 15: Health Care During an Emergency in an Unfamiliar Setting- Lessons & Strategies to Help 

Date: March 27, 2012
Time: 11:00 - 11:30 am EDT

Would you know how to obtain emergency care while you were traveling or if you had just relocated to a new part of the country? Co-hosts Mallory Cyr and Teresa Nguyen will share their experiences, lessons learned, and strategies for obtaining care in new settings, including how to bring staff up to speed on special health care needs. Register for this event. Listen to previous broadcasts by the National Health Care Transition Center. 

National Center for Ease of Use of Community-Based Services webinar: Ease of Use of Services for Latino Families with Children with Special Health Care Needs: Lessons from an Action Learning Collaborative in North Carolina and Oregon

Date: April 2, 2013
Time: 1 - 2 pm EDT

This is the first of three webinars the National Center for Ease of Use of Community-Based Services and the Association of Maternal and Child Health Programs (AMCHP) are hosting about ways to reduce disparities in the use of community-based services and how Title V Children with Special Health Needs programs can help. Register for this webinar.