• June 2012
  • Vol. 13, No. 5

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Medicaid Managed Care Toolkit

A new toolkit published by the Center for Health Care Strategies (CHCS)—Improving Outcomes for Children in Child Welfare: A Medicaid Managed Care Toolkit—offers States and communities strategies for improving collaboration between child welfare agencies and Medicaid managed care organizations (MCOs). Because children involved with child welfare experience more physical, emotional, and behavioral health conditions than the general population and have higher health care utilization rates, the toolkit addresses ways to improve child health outcomes through better access to and appropriate use of Medicaid services. Many professionals will find the information in the toolkit timely and relevant—not only do a majority of States offer Medicaid to children in child welfare, but more are likely to do so as the Patient Protection and Affordable Care Act of 2010 extends health care coverage to former foster youth up to age 26.

The toolkit is based on the experiences of nine MCOs that participated in a CHCS Quality Improvement Collaborative funded by the Annie E. Casey Foundation from 2007 to 2009. Through the collaborative, the MCOs assessed child health care systems, then developed and implemented plans to improve coordination and services primarily for children in foster care and those with subsidized adoptions, serving 71,000 children overall. The toolkit contains lessons learned in the following areas:

  • Increasing data quality on children in child welfare in order to identify and target those most in need of health services
  • Creating greater continuity of health care for the highly mobile child welfare population by improving ease of access to screenings, assessments, and primary care services
  • Coordinating numerous professionals serving children to ensure the development and execution of an effective health care plan
  • Determining appropriate use of services and levels of care for children in child welfare, especially regarding psychotropic medication
  • Breaking down systems-level barriers to collaboration among MCOs, child welfare agencies, and other organizations serving children, such as workforce training and information-sharing policies
  • Engaging children's birth, kinship, and foster family members to ensure understanding and coordination of health care services

The toolkit identified several key "takeaways" for implementing a plan to improve Medicaid services for children in child welfare, such as fostering professional partnerships at all organizational levels, setting clear roles and responsibilities of partners, and reliably gathering and analyzing data in order to support continuous improvement. Because all the MCOs involved with the collaborative saw improvements in the health of children in child welfare, even in relatively short timeframes, the toolkit concludes by encouraging all States and communities to consider developing and implementing plans to improve outcomes for the children they serve.

The toolkit was written by K. D. Allen, S. A. Pires, and R. Mahadevan, and was edited by S. Chazin and A. Baruchin; it is available to download on the CHCS website:

http://www.chcs.org/usr_doc/Child_Welfare_Quality_Improvement_Collaborative_Toolkit.pdf (2 MB)

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