CISWH Project Resources

An hour-long webinar held on June 20, 2016 to “get acquainted” with the tutorial, Health Care Coverage and Financing for Children with Special Health Care Needs: A Tutorial to Address Inequities. MCH staff from Alaska and Michigan share strategies they use to work towards health equity for CSHCN in their states.
View detailed webinar description

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.

En español
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.

This fact sheet from the Catalyst Center explores strategies states can use to close the health care coverage and financing gaps experienced by Latino families raising children with special health care needs. 

The Catalyst Center interviewed staff from family leadership organizations in five states to learn about the barriers underserved families face and the strategies these organizations use to address health insurance inequities among CSHCN in their communities. This policy brief describes the strategies that help promote access to coverage and financing of care among CSHCN including racial and ethnic minority children, older children, those living in immigrant families or in families in which English is not the primary language, and those with the most significant functional limitations. 

Certain vulnerable subgroups of children with special health care needs (CSHCN) face underlying structural disadvantage in terms of health care coverage. Differences exist within the population of CSHCN based on race, ethnicity, income, immigration status, language, and level of functional difficulty. This tutorial clarifies the language used to describe these differences and provides tools and examples of policies, programs, and partnerships that users can adopt in their states to improve access to coverage and financing of care for the most vulnerable children. An accompanying interactive worksheet helps users distill the information presented to identify health care coverage and financing inequities that may exist for CSHCN in their state or organization. The completed worksheet provides information that may serve as a starting point for discussions in how to address inequities for CSHCN.
View description of webinar introducing this tutorial.