Alternative payment models promote novel care-delivery systems and greater accountability for health outcomes With a focus on population health, patient-centered medical homes, and care coordination, this model holds the potential to promote care-delivery systems that address the unique needs of children with medical complexity, including nonmedical needs and the social determinants of health.
Sufficient access to needed services for children with medical complexity is not assured and varies considerably by payer, many of whom who face pressures to control health spending. This article reviews the rights of children with medical complexity in Medicaid, the Children’s Health Insurance Program, and various forms of private health insurance to receive services that are necessary to promote optimal health, development, and family functioning.
Families authentically involved at every level of health care systems are critical partners in designing policies and systems that will improve care for children with medical complexity. Written by a group of parents, this article provides an overview of the demands of managing care from their unique perspective.
Health care systems are increasingly using a process known as "risk tiering" to group patients with similar degrees of need for health care and care coordination services. Families and care providers of children with chronic and complex conditions should understand the risk tiering process, as it may affect access to services these children need. This report outlines how tiering currently is being used, and makes recommendations for policy and research.
Children and youth with special needs are best served through a coordinated approach across the myriad programs and agencies whose services they need. In two new reports, Health Management Associates highlights how six programs in five states have made progress in overcoming the frustrating barriers to interagency collaboration among programs that serve these children and their families. The reports offer recommendations on how states might foster efforts to improve communication and coordination across programs and reduce fragmentation and duplication of services.
Learning social skills is a cumulative, lifelong task that can have a profound effect on many aspects of an individual’s life. Social skills can be taught and reinforced at all ages and in numerous social settings. Greater attention to supporting the kinds of social interactions that improve relationships can contribute to individual growth and a more equitable and just society.
In May 2017, the National Health Law Program brought together stakeholders from around California to discuss potential legal interventions to improve access to mental health services for children with special health care needs. This fact sheet summarizes their recommendations for action.
Evidence shows that to create a high-quality health care system, the family perspective must be actively pursued and incorporated at all levels -- direct care, organizational design and governance, and policymaking. A new fact sheet outlines the value of family engagement and the barriers that prevent its implementation, along with recommendations for improvement.