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
"The hardest thing in the world to understand is the income tax"
~ Albert Einstein
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Featured Article
By Reem M. Ghandour, Meg Comeau, Carol Tobias, Beth Dworetzky, Rose Hamershock, Lynda Honberg, Marie Y. Mann, and Sara S. Bachman
Academic Pediatrics
April 10, 2015
(Full disclosure: Meg and Beth are staff at the Catalyst Center, a project of the Health & Disability Working Group, which Sara directs.)
Using data from the National Survey for Children with Special Health Care Needs, the authors examined the 10-year trend in progress towards "adequate private and/or public health insurance and financing to pay for the needed services" for children with special health care needs (CSHCN). This financing measure is one of six Maternal and Children Health Bureau (MCHB) core outcomes for CSHCN. Overall, from 2001 to 2009-10, there was a decrease in the number of CSHCN without insurance. Other findings include:
- A decline in the number of CSHCN with private insurance and an increase in the number of CSHCN with public coverage;
- Adequacy of insurance (insurance usually or always covered needed services, out-of-pocket costs that were usually or always reasonable, and child's insurance usually or always provided access to needed health providers) improved for children with public coverage;
- For children with private coverage, there was no change in covered services or ability to see needed providers; however, an increased number of families reported the out-of-pocket costs were not reasonable;
- Inequities in coverage persist for CSHCN by race/ethnicity, age, functional status, and household income.
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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
Time to Raise a Glass: CHIP Funding Extension Headed to President's Desk! 
By Elisabeth Wright Burak
Center for Children and Families: A Children's Health Policy Blog
April 14, 2015
On March 26, the U.S. House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, and on April 14, the Senate followed suit. President Obama signed the bill on April 16. MACRA repeals the SGR, the sustainable growth rate formula, used annually to control Medicare spending on physician services. However, those concerned about children's health coverage are celebrating the two years of extended funding for the Children's Health Insurance Program (CHIP) included in the bill. MACRA also preserves the Affordable Care Act's 23% increased match rate for CHIP; maintains Medicaid eligibility for 6- to 19- year-olds up to 138% of the federal poverty level; extends Express Lane Eligibility (ELE) and Maintenance of Effort through 2017 and 2019 respectively; and includes $40 million for the Children's Health Insurance Program Reauthorization Act outreach and enrollment grants. This legislation also extends funding for the Family-to-Family Health Information Centers and community health centers.
CHIP Success: Where Do We Go From Here?
By Kate Lewandowski
Community Catalyst's Health Policy Hub
Apr 16, 2015
This blog acknowledges the relief children's advocates felt on April 14 when the Senate approved H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. This legislation, which extends funding for the Children's Health Insurance Program (CHIP), literally "buys" time--two years--for children who rely on CHIP for health care coverage. Moving forward, advocates need to focus on polices that will 1) ensure smooth transitions between CHIP and Marketplace plans, and 2) guarantee children have access to comprehensive benefits and needed providers.
By Terrence McCoy
The Washington Post
April 13, 2015
From 2013 to 2014, the District of Columbia Medicaid program saw a 30% increase in the number of children who received mental health services. This gain is attributed to increased spending, increased oversight of Medicaid mental health providers, and to pediatricians who are now reimbursed for providing mental health screenings. Despite this good news, concerns remain about the number of children who continue to have an unmet need for mental health services, the quality of the services, and the long wait for appointments.
By Michelle Diament
Disability Scoop
April 16, 2015
Researchers at the Oregon Health and Science University compared the age of diagnosis for children with autism spectrum disorders (ASD) to the age of diagnosis for children with intellectual disability and developmental delays (ID/DD). They found that children with ID/DD are diagnosed at earlier ages. The difference, in part, is due to the health care provider. When parents' concerns about their child's development were met with a "wait and see" response, there was a year or more delay in an ASD diagnosis. Improved education and training for physicians, as well as following the American Academy of Pediatrics (AAP) guidelines for developmental screenings, should lead to earlier diagnoses and referrals to services and supports.
Modern HealthcareApril 15, 2015The U.S. Government Accountability Office (GAO) issues an annual report that identifies ways federal agencies can cut costs. This year's report, Opportunities to Reduce Fragmentation, Overlap, and Duplication, and Achieve Other Financial Benefits, recommends changes to the process the Centers for Medicare and Medicaid Services (CMS) uses to approve Medicaid demonstration projects. Improving the review criteria for demonstration projects and ensuring cost-neutrality would lead to considerable savings.
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Resources
By Grace Anglin and Mynti Hossain
Agency for Healthcare Research and Quality
April 2015
Evaluation Highlights from the Agency for Healthcare Research and Quality (AHRQ) shares descriptions and analyses about the work of the Children's Health Insurance Program Reauthorization Act (CHIPRA) quality demonstration grantees. Highlight number 11 presents findings from Alaska, Florida, Illinois, Maine, Massachusetts, and North Carolina. These six states used quality reports to drive improvement in quality of health care for children. Some states focused on state-level improvements, others focused on policy and programmatic changes, and some states did both. Technical assistance was needed at the practice level to establish quality improvement processes and the use of data to track progress.
Every year, the Maternal and Child Health Bureau (MCHB) publishes a databook with more than 50 indicators about current and historical data about children's health. It provides data about population characteristics, health status, and health services. The special features section includes information about the Affordable Care Act (ACA) and federal programs to promote child health. Each section includes a narrative, data, and downloads. Users can query data by age, sex, race/ethnicity, urban/rural residence, family structure, poverty level, and more.
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Events & Announcements
Webinar: Special Enrollment Periods and Resources for the Uninsured Date: May 6, 2015Time: 2:00 to 3:00 pm ETCertain life events such as turning 26, getting married, or having a baby can affect health insurance status, necessitating the need to enroll in different health coverage. The Affordable Care Act (ACA) allows for Special Enrollment Periods (SEPs) so individuals and families who experience qualifying life events can enroll in Marketplace coverage outside of an open enrollment period. Join this webinar to learn about SEPs as well as 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 (415) 655-0059, Access Code: 419-734-181. The PIN is the # key.
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In case you missed it... the most popular news item from our last issue
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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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