Medicaid Managed Care - U.S. Senate Special Committee on Aging
Medicaid Managed Care - U.S. Senate Special Committee on Aging Medicaid Managed Care - U.S. Senate Special Committee on Aging
Prface 648 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
649 During the past year, expert work groups for the first four priorities were convened, each for a day and a half meeting. Work group members included federal and state Title V officials. federal and state
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- Page 642 and 643: 640 APPENDIX C ENDNOTES 1. See, for
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649<br />
During the past year, expert work groups for the first four priorities were c<strong>on</strong>vened, each<br />
for a day and a half meeting. Work group members included federal and state Title V officials.<br />
federal and state <str<strong>on</strong>g>Medicaid</str<strong>on</strong>g> agency staff, managed care plan representatives, pediatric providers,<br />
representatives from family organizati<strong>on</strong>s, and health services researchers.<br />
This report is a summary of the proceedings from the first four meetings and for each it<br />
includes a problem statement, examples of current research and innovative approaches, and<br />
recommended activities. Also included is a listing of the expert work group members and<br />
bibliographic references. The report. was prepared by the Maternal and Child Health Policy<br />
Research Center with the assistance of the Georgetown University Child Development Center.<br />
Copies of this report are also available through the MCH NetLink-at the following address:<br />
http://www.ichp.ufl.edu/MCHBMCH-NetLink.<br />
The Maternal and Child Health Bureau will be c<strong>on</strong>sidering these findings and<br />
recommendati<strong>on</strong>s al<strong>on</strong>g with others to develop new research and dem<strong>on</strong>strati<strong>on</strong> grant guidelines.<br />
technical assistance materials, and policy statements. In the coming year, MCHB plans to<br />
c<strong>on</strong>tinue work <strong>on</strong> developing operati<strong>on</strong>al approaches for identifying children with special health<br />
care needs for managed care purposes. We will c<strong>on</strong>tinue to keep you informed of this and other<br />
work <strong>on</strong> managed care.<br />
Merle McPhers<strong>on</strong>, M.D.<br />
Director<br />
Divisi<strong>on</strong> of Services for Children with <str<strong>on</strong>g>Special</str<strong>on</strong>g> Health <str<strong>on</strong>g>Care</str<strong>on</strong>g><br />
Needs<br />
Maternal and Child Health Bureau<br />
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