Catalyst Center Coverage
Roundup of news related to financing of care for children and youth with special health care needs |
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Quote of the Week
"He who knows best knows how little he knows."
~ Thomas Jefferson
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Featured Article
By Jenny Gold Kaiser Health News April 7,
2015
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 IN THIS ISSUE
Featured Article
News
Resources
Events and Announcements
In Case You Missed It...
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News Items
Insurers, Doctors Partner to Improve Patient Care, Cut Costs 
By Virginia Anderson
The Atlanta Journal-Constitution
April 6, 2015
The Affordable Care Act (ACA) reduced the number of people who were uninsured. Now it's working to improve quality of care. Nationwide, primary care physicians, specialty providers, hospitals, and insurers are working together to improve patient health, and they are being rewarded for their efforts. In this move away from fee for service, the focus is on quality of services, not quantity. Read how an enhanced personal health care model helped one family coordinate care, track test results, and ensure their daughter's multiple health needs were met.
ACE Kids Act Could Help with Medical Care
By Kyle Dyer
KUSA
April 6, 2015
As explained by a family raising a young boy with spina bifida, not every family raising a child with special health care needs is lucky enough to live close to a children's hospital that can provide critical specialty services. It's not unusual for families to travel across state lines or across the country to access specialty pediatric services for their children with complex needs. This makes it difficult for families to coordinate their child's care, and it makes it difficult for hospitals, which have to deal with out-of-state Medicaid programs. With the ever-present concern about cuts to Medicaid, Congress and hospitals are working to streamline Medicaid payments across state lines and reduce Medicaid costs by coordinating care for children with complex health needs. These efforts are detailed in the Advancing Care for Exceptional Kids (ACE) Act of 2015 ( S. 298 / H.R. 546), which would make it a state option to participate and a family option to accept pediatric care management services.
By Shadi Houshyar
First Focus: Voices for Kids Blog
April 7, 2015
In January 2014, a provision of the Affordable Care Act (ACA) that extends Medicaid coverage to age 26 for children who age out of foster care went into effect. While this provision is mandatory for all states, states do not have to provide Medicaid to youth who aged out of foster care in another state. On April 7, New Mexico became the thirteenth state to recognize the importance of continued coverage for this vulnerable population by opting to provide Medicaid benefits to youth who aged out of foster care in another state.
By Stacey McMorrow, Genevieve M. Kenney, Sharon K. Long, and Nathaniel Anderson
Health Affairs
April 2015
The uninsurance rate for young adults has decreased substantially due to the provision of the Affordable Care Act (ACA) that allows parents to keep their young adult children on their health plans until they turn 26. This provision has been particularly helpful to young adults with higher incomes, who would not be eligible for Medicaid in states that expand Medicaid, but for whom purchasing health insurance might be unaffordable.
Shifts in Earnings for Consumers Near Medicaid Line Can Threaten Coverage By Michelle Andrews
Kaiser Health News
April 7, 2015Changes in income, family size, and employment status affect eligibility for health coverage. The expansion of Medicaid and the creation of the health benefits Marketplaces created new coverage options. Eligibility for a particular coverage pathway depends, in part, on household income. So, what happens when income changes? This article examines churn (transition between Medicaid and Marketplace coverage), a woman's experience with transition between these two coverage types, and what states can do to reduce churn.
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Resources
By Dottie Rosenbaum
Center on Budget and Policy Priorities
March 31, 2015
This report examines churn in SNAP (Supplement Nutrition Assistance Program), Child Care assistance, and Medicaid and the Children's Health Insurance Program (CHIP). Churn "costs" to families include gaps in coverage, delayed or forgone care, and increased out-of-pocket expenses for health services. Churn "costs" to states include increases in both workload and expenses to process reapplications for eligible families who have lost coverage. The author provides three methods for measuring churn. She also shares strategies for reducing churn, which include aligning renewals and eligibility redeterminations among public assistance programs, and improving and simplifying communications to families.
The Impact of the Coverage Gap in States not Expanding Medicaid by Race and Ethnicity
By Samantha Artiga and Jessica Stephens
The Kaiser Family Foundation
April 3, 2015
This issue brief examines the coverage gap that exists in the 22 states that are not moving forward with the optional Medicaid expansion provision of the Affordable Care Act (ACA). The gap represents adults whose income is too low (less than 100% of the federal poverty level) to qualify for subsidies to purchase Marketplace coverage and too high to be eligible for Medicaid. And, as the figures demonstrate, people of color are disproportionately represented in the gap, resulting in increasing health coverage inequities.
News From Our Partners
National MCH Workforce Development Center: Cohorts 3 & 4 Trainings
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Events & Announcements
From now until April 30, 2015, there is a Special Enrollment Period (SEP) in place for individuals and families who owe a tax penalty for 2014 and who are still uninsured. Outside of the tax SEP, there are other life events that merit a SEP. These include: turning 26, getting married, or having a baby (not necessarily in that order). Join this webinar to learn more about SEPs and enrolling in Marketplace coverage. This is also an opportunity to learn about resources for those who are not eligible for a SEP. Register for the Special Enrollment Periods and Resources for the Uninsured webinar . To join by phone only, dial (702) 489-0007, Access Code: 669-927-957. The PIN is the # key.
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Want more news?
To view more articles from past issues of Catalyst Center Coverage, visit the Catalyst Center website. Or follow the Catalyst Center on Facebook or Twitter.
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News to share?
If you have suggestions for news items related to coverage and financing of care for CYSHCN please email Beth Dworetzky Catalyst Center Coverage editor and Catalyst Center Project Director by 12 noon on Friday.
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The Catalyst Center is a national center dedicated to working with states and stakeholder groups on improving health care insurance and financing for Children and Youth with Special Health Care Needs (CYSHCN). For more information, please visit us at www.catalystctr.org or contact Meg Comeau, Co-Principal Investigator, at mcomeau@bu.edu.
The Catalyst Center, the National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs, is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U41MC13618, $473,000. This information or content and conclusions are those of the Catalyst Center staff and should not be construed as the official position or policy of nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government. LT Leticia Manning, MPH, MCHB/HRSA Project Officer.
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