CISWH Project Resources

On February 13th at the 2018 Association of Maternal & Child Health Programs (AMCHP) conference the Catalyst Center presented the results of four focus groups that were conducted with parents of children and youth with special health care needs (CYSHCN) who are from the Somali community in Boston, focusing on accessing health care for their CYSHCN.

In the context of the focus group results, we also provided results of interviews conducted with representatives of state Offices of Minority Health. We presented information on innovative strategies states are using to mitigate inequities and discussed how these strategies could address the barriers the families identified. The session was recorded, and the video will also be available here in the coming months.

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.

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: 

• The Catalyst Center and the AAP produced a special supplement to Pediatrics on VBP and value-based insurance design (VBID) and their potential implications for CYSHCN. Read the supplement, available free of charge.
• The Catalyst Center produced A Primer On Value-Based Strategies For Improving Financing Of Care For Children And Youth With Special Health Care Needs, which focuses on opportunities to increase value in spending on health services for CYSHCN through select alternative payment mechanisms and delivery innovations. It also highlights potential roles for Title V and family leaders in these efforts.
• The Affordable Care Act And Value-Based Purchasing: What’s At Stake For Children With Medical Complexity? is a Catalyst Center product which examines the VBP strategies of (1) pay-for-performance (P4P); (2) accountable care organizations (ACOs), and (3) bundled payments. These strategies are geared towards achieving value by reducing costs while improving quality based on a predetermined set of performance standards.

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.

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.

In this webinar, which took place on April 26, 2017, Catalyst Center staff introduced the updated edition of Breaking the Link Between Special Health Care Needs and Financial Hardship. They presented about the impact that health care financing and coverage gaps have on the lives of real families and highlighted innovative policy solutions that can improve the system of care for children and youth with special health care needs (CYSHCN). 

Slides from this webinar are available below.