CISWH Project Resources

The Boston Public Health Commission (BPHC) Planning Council partnered with the Center for Advancing Health Policy and Practice for the 2017 Needs Assessment report. The goal was to identify barriers that prevent people living with HIV, both in and out of care, from receiving needed services, engaging in care, and/or adhering to medication regimens.

During this interactive webinar course, the first in a series and presented on July 27, 2017, participants learn why community health workers (CHWs) could be key to reducing barriers to care faced by underserved and hard-to-reach populations, specifically in HIV systems. The course defines the role of CHWs, how they are integrated into health care teams, and how they function as an integral part of the health care system. Experts share real-world illustrative examples of CHWs working in HIV care. Participants learn about building—and expanding—internal capacity for CHWs.
View the video and access webinar slides below.

There is broad agreement that increasing the cost-effectiveness and quality of health care services, thereby achieving greater value, is imperative given this country’s current spiraling costs and poor health outcomes. However, how individuals or stakeholder groups define value may differ significantly. To date, the consumer perspective has been underrepresented in discussions of value-based strategies such as pay for performance, capitated and bundled payments, and high-deductible health plans, which have been driven primarily by payers and providers. This article will discuss 3 elements of value from the perspective of families of children and youth with special health care needs: the role of families in the delivery of care, consumer perspectives on what constitutes quality for children and youth with special health care needs, and health care and health care financing literacy, decision-making, and costs. The undervalued contributions made by family members in the delivery and oversight of pediatric care and the importance of partnering with them to achieve the goals of the Triple Aim are stressed. The article closes with a discussion of recommendations for a future policy and research agenda related to advancing the integration of the consumer perspective into value-based purchasing and value-based insurance design.

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.  

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.  

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.  

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.

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.

For a HRSA meeting on June 27, 2017, each SPNS demonstration site created a poster presentation outlining the model that was developed as part of the initiative Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations. Each poster includes findings, successes and challenges and next steps.

Each demonstration SPNS project has created a manual that outlines the model of care developed as part of the initiative Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations. These manuals, together with a multisite manual that provides an overview of the initiative, can be found at the link below.

The nine sites that participated in the initiative Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations created videos to show how their model of care improved the health and well-being of clients who were living with HIV and experiencing homelessness.