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

C. Recommnended Atihitles
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While there is no accepted operational approach that rmanaged care plans can use to
identify children with special needs, there are several alternate strategies states and plans might
consider, each with its own strengths and weaknesses. These include diagnostic, functional.
service, categorical, or combined approaches. The expert work group suggested several
recommendations.
1. Most existing approaches for identifying children with special health needs have
serious limitations. Several new tools will be available soon that will help
improve the identification of these children, including those developed by Stein
et al., NACHRI, and Landgraf. Until then, states should continue their efforts
at developing creative identification mechanisms.
2. State Title V programs, plan managers, health professionals, families, and
academics should begin to work together regarding the development and
application of improved systems for identification, building on the new tools
soon to be available.
3. Emerging efforts by states and managed care plans for identifying children with
special health care needs should be monitored. Promising new efforts should be
identified and evaluated.
4. Additional attention is needed to develop mechanisms for identifying children at
risk for special service needs. Currently, there is little agreement in the field
about which children are at risk.
S. A national profile of the number and characteristics of children with special
health needs, based on MCHB's definition, should be developed using new
information from the National Health Interview Survey on Disability. This
profile can be used as a national baseline for monitoring changes over time in
access, satisfaction, and use of services by children with special health needs.
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