If you have clients who are newly insured and need help understanding their policy, give them this guide as a resource: “Making the Most of Your Coverage”. The guide explains important insurance documents, key insurance terminology, understanding how to anticipate health care costs, knowing where to go for care, and how to make the most out of each doctor visit.
The Catalyst Center has created a one-page infographic illustrating the importance of partnerships in advancing financing and coverage for children and youth with special health care needs (CYSHCN). This infographic provides a brief explanation of the power of partnerships and highlights examples of partnerships with important stakeholders.
This is one page in a series of infographics exploring key focus areas in the world of health care financing and coverage for CYSHCN.
These one-pagers are a visually appealing and easy way to share information about the system of care for CYSHCN with stakeholders. Resources for further information about leveraging partnerships for CYSHCN are listed at the bottom of the infographic.
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.
Desarrollado por el National Center for Medical Home Implementation de la Academia Americana de Pediatría y el Catalyst Center de la Escuela de Salud Pública de la Universidad de Boston
The Patient Protection and Affordable Care Act of 2010 (ACA) contains provisions that are designed to improve major gaps in the health care coverage, financing and delivery system that prevent children and youth with special health care needs (CYSHCN) from accessing health care services or which impose significant financial hardship on their families. The law is designed to increase coverage, improve benefits and provide important new insurance protections for all Americans. Many of the law’s provisions will impact children, including CYSHCN, and all will be implemented over time. This fact sheet offers a concise description of some of the provisions under ACA that directly impact CYSHCN and offers some thoughts about the role of State Title V MCH and CYSHCN programs in realizing their promise.
The Maintenance of Effort (MOE) provisions under the Affordable Care Act (ACA) requires states to keep the eligibility criteria for their Medicaid and Children’s Health Insurance Program (CHIP) that they had in place on March 23, 2010, the day the ACA was signed into law. Under MOE, states cannot make it more difficult to enroll in or renew Medicaid or CHIP coverage. For children in Medicaid and CHIP, the MOE provisions are in effect until September 30, 2019. States who violate the MOE provisions risk losing their federal funding match.
Section 2703 of the ACA describes a state plan option to provide health homes for Medicaid-enrolled individuals with at least two chronic conditions, one chronic condition and the risk of developing a second, or one serious and persistent mental health condition. This presentation, given at the 2014 AMCHP conference, provides and overview of this provision of the ACA, highlights strategies states have used to include CYSHCN in their Medicaid Health Homes, efforts for sustaining the Health Home after the two years of enhanced funding ends, and lessons learned.
Created by the National Center for Medical Home Implementation and the Catalyst Center, these four plain language fact sheets, “Your Child’s Health and the Affordable Care Act,” explain specific provisions of the Affordable Care Act which benefit children and youth with special health care needs.
On July 20, 2015, experts from the Catalyst Center and the National Center for Medical Home Implementation shared information on how ACA provisions outlined in the above fact sheets can help families raising children with special health care needs. Slides and resources from the webinar are available below.
The implementation of the ACA shifted the structure and design of public and private health care delivery and payment systems. In order to curb health care spending and improve quality of care and health outcomes, there has been tremendous attention to value as a criterion for health insurance options offered by payers. Value-based purchasing strategies, primarily (1) pay-for-performance (P4P); (2) accountable care organizations (ACOs), and (3) bundled payments, are geared towards achieving value by reducing costs while improving quality based on a predetermined set of performance standards including quality and cost measures. These strategies are discussed in this policy brief.
Efforts to reduce health care costs and promote quality have led to new ways to pay for health services. This glossary can help Title V staff, family leaders, policymakers, providers, advocates, and others become familiar with alternative payment strategy definitions.