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Addressing Chronic Disease through Community Health Workers: A Policy and Systems-Level Approach

A CDC Division for Heart Disease and Stroke Prevention-published policy brief. Provides guidance and resources for integrating CHW into community-based efforts to prevent chronic disease. Provides general information on CHW in the U.S., then details the value and impact of CHW in preventing and managing a variety of chronic diseases, including heart disease and stroke, diabetes, and cancer. Provides descriptions of CHW chronic disease programs, examples of state legislative action, recommendations of policies for building an integrated and sustainable CHW workforce, and resources that can assist state health departments in working with CHW.

Congressional Briefing: Pathways to Medicaid Coverage for Children with Special Health Care Needs

In March of 2017, Catalyst Center staff gave an in-person presentation to Congressional staffers on “Pathways to Medicaid Coverage for Children and Youth with Special Health Care Needs”. This presentation included an overview of the Catalyst Center, data on publicly funded coverage and financing of care for Children with Special Health Care Needs (CYSHCN), the importance of Medicaid coverage for CYSCHN with regard to adequacy, affordability and access to care, pathways to coverage based on 1) income alone, 2) income and health status, 3) severe disability and 4) involvement with the child welfare system (foster care). Finally, a variety of Catalyst Center technical assistance resources on Medicaid and CHIP were highlighted.

Webinar: The Role of Title V Programs and Value-Based Purchasing for Children and Youth With Special Health Care Needs

On December 6, 2017, the Catalyst Center and the American Academy of Pediatrics (AAP) co-hosted a webinar on state-based innovations that support value-based purchasing (VBP) for children and youth with special health care needs (CYSHCN). Presentations from the Association of Maternal and Child Health Programs (AMCHP), and the state Title V programs in Oregon and Colorado helped to define the role of Title V programs in relation to value-based purchasing arrangements, discussed specific program examples and shared lessons learned. A YouTube video of the webinar, as well as the slides, are available below.

For further learning about VBP we have links to related reading material from the Catalyst Center: 

Statement of the Problem: Health Reform, Value-Based Purchasing, Alternative Payment Strategies, and Children and Youth with Special Health Care Needs

With the increasing emphasis on value-based purchasing (VBP), policymakers must critically analyze the potential impact for children and youth with special health care needs (CYSHCN), because this group of children, by definition, uses more health care services than other children and inevitably incurs higher per person costs. We provide a history and definition of VBP and insurance design, noting its origin in employer-sponsored health insurance, and discuss various financing and payment strategies that may be pursued under a VBP framework. The relevance of these approaches for CYSHCN is discussed, and recommendations for next steps are provided. There is considerable work to be done if VBP strategies are to be applied to CYSHCN. Issues include the low prevalence of specific special health care need conditions, how to factor in a life course perspective, in which investments in children’s health pay off over a long period of time, the marginal savings that may or may not accrue, the increased risk of family financial hardship, and the potential to exacerbate existing inequities across race, class, ethnicity, functional status, and other social determinants of health.

This article was part of a May 2017 supplement in Pediatrics, produced by the Catalyst Center and the American Academy of Pediatrics (AAP). The Catalyst Center staff along with colleagues from the AAP presented a webinar with key highlights from each of the Pediatrics supplement papers.  

Refining Our Understanding of Value-based Insurance Design and High Cost Sharing on Children

There is significant concern about the financial burdens of new insurance plan designs on families, particularly families with children and youth with special health care needs (CYSHCN). With value-based insurance design (VBID) plans growing in popularity, this study examined the implications of selected VBID cost-sharing features on children.

This article was part of a May 2017 supplement in Pediatrics, produced by the Catalyst Center and the American Academy of Pediatrics (AAP). The Catalyst Center staff along with colleagues from the AAP presented a webinar with key highlights from each of the Pediatrics supplement papers.  

A Primer on Value-based Strategies for Improving Financing of Care for Children and Youth with Special Health Care Needs

Value-based purchasing and value-based insurance design are gaining increasing attention as strategies for reducing health care spending and improving health outcomes – “value” being the operative concept. However, there is not enough evidence to date regarding the effectiveness of these strategies; what does exist is primarily focused on interventions impacting adults. This primer focuses on opportunities to increase value in spending on health services for children and youth with special health care needs (CYSHCN) through select alternative payment mechanisms and delivery innovations, and potential roles for Title V and family leaders in these efforts.

Leveraging Title V Partnerships to Advance National Performance Measure # 15: Adequate Health Insurance

The Maternal and Child Health Bureau (MCHB) encourages state Title V programs to partner with families, consumer groups, and others to advance their chosen National Performance Measures (NPMs). As the MCHB-funded national center for health insurance and financing of care, the Catalyst Center researches and disseminates state-level financing strategies aimed at improving health insurance coverage for children and youth with special health care needs (CYSHCN). Our work aligns with NPM #15: “Adequate Insurance Coverage: percent of children ages 0 through 17 who are adequately insured.” This policy brief describes Title V, family leader organization, and Medicaid partnerships that can help states make progress on improving access to adequate insurance for CYSHCN.

Webinar: Innovative Health Care Financing Strategies for Children and Youth with Special Health Care Needs: a supplement to the May 2017 issue of Pediatrics

The Catalyst Center and the American Academy of Pediatrics (AAP) produced a special supplement to Pediatrics on value-based purchasing (VBP) and value-based insurance design (VBID) and their potential implications for children and youth with special health care needs (CYSHCN). Read the supplement, available to all free of charge.

In this June 13, 2017 webinar, Catalyst Center staff along with colleagues from the AAP presented an overview of VBP/VBID and their potential implications for CYSHCN, the perspective of families of CYSHCN on value and quality, key highlights from each of the Pediatrics supplement papers, and recommended resources.

Title V and Medicaid/CHIP Interactive Worksheets

The Catalyst Center created two interactive worksheets for Title V program staff, family leaders, and other stakeholders. These worksheets provide an overview of Title V, and Medicaid and the Children’s Health Insurance Program (CHIP). Each worksheet includes resources you can use to find and insert state-specific information to help demonstrate the importance of Title V, Medicaid and CHIP for children with special health care needs (CSHCN). The worksheets were created as companion materials to the Catalyst Center’s Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and the Children’s Health Insurance Program (CHIP).

State Statutes & Regulations on Dietary Treatment of Disorders Identified Through Newborn Screening

Every state has a Newborn Screening (NBS) Program which screens newborns for a variety of health conditions, including selected inborn errors of metabolism (IEMs) and other genetic disorders. Individuals with genetic conditions identified through NBS programs often require Modified Low Protein Foods (MLPFs), medical foods, dietary supplements, or other dietary treatments as well as enteral feeding supplies. Due to the wide-ranging funding mechanisms across states, coverage for these categories of products and supplies varies based on type of insurance coverage (e.g., public or private), type of health plan (e.g., individual, group, HMO), and any coverage and or related services that Title V or other state programs may fund.

This resource provides information about state-specific legislation that mandates the coverage of medically necessary foods by employer-sponsored health insurance and Medicaid, and coverage and related services funded by other state programs such as Title V or relief funds. It also details the covered services as well as any benefit limits or age and income restrictions. This report builds on a 2008 report of the same name by Alissa Johnson, and an update to that report from the Catalyst Center and the National Coordinating Center for the Regional Genetics Networks (NCC) published in 2016.