Medicaid Managed Care - U.S. Senate Special Committee on Aging

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The U.S. Maternal and Child Health Bureau (MCHB) has as its mission the establishment
of family-centered, comprehensive, coordinated care for all children with special health care
needs. These principles were first articulated by former Surgeon General C. Everett Koop in
1982 and again in the new MCHB National Agenda.' These principles have significantly changed
the way services are provided to children and their families in this country.
While the principles set forth in the National Agenda have not changed, two major trends
have taken place in the 1990s that will continue to influence how children receive health care
services. First, the emergence of managed care has dramatically changed how health services are
delivered and financed. Second, public health responsibilities are diminishing and shifting from
the federal to state levels. As we make these transitions, it is critical that managed care programs,
public and private purchasers, Title V agencies, families, and health professionals work together
to reinforce and advance the gains made in the last two decades. Clearly, we still have a long way
toward making the principles of family-centered, comprehensive, coordinated care a reality.
The MCHB recognizes that this is a critical time to provide national leadership to improve
managed care services for children with special health care needs. We have developed a managed
care strategic planning agenda that addresses seven areas:
I. defining and identifying children with special health care needs,
2. family participation,
3. capitation and risk adjustment,
4. quality of care,
5. pediatric provider and service requirements,
6. provider capacity development, and
7. health and related services integration.
Matemal and Child Health Bureau .Voaoonal/Agenda for Children with <strong>Special</strong>Health <strong>Care</strong> Needs: Achieving the
Goals 20M. Rockville. MD: MCHB, Health Reaource and Smerices Administration, 1995.
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