Medicaid Managed Care: Challenges and Opportunities for Pediatric Medical Home Implementation and Children and Youth with Special Health Care Needs
Children and youth with special health care needs (CYSHCN) who have or are at risk for physical, developmental, behavioral, or emotional chronic conditions have increased needs for health-related services. In an effort to reduce health care costs and potentially improve quality of care, states are expanding managed care programs for Medicaid beneficiaries with complex conditions, including some CYSHCN.
The National Center for Medical Home Implementation, in collaboration with the National Academy for State Health Policy, created a fact sheet that discusses challenges and opportunities to provision of care for CYSHCN enrolled in Medicaid managed care. The fact sheet identifies states that leverage Medicaid managed care to advance the pediatric medical home model through payment incentives, technical assistance, and care coordination services.