EPSDT
FEATURED ARTICLE
Coverage of Maternal, Infant and Early Childhood Home Visiting Services
/in Policy South Carolina Blogs, Webinars Behavioral/Mental Health and SUD, Care Coordination, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, EPSDT, Health Coverage and Access, Health Equity, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by Alexandra KingResearch has shown that a quality home visit by a nurse, social worker, early childhood educator or other trained personnel during pregnancy and early parenting can improve the lives of families and their children both at an early age and well into adolescence and early adulthood. The Centers for Medicare and Medicaid Services (CMS) and […]
Potential Options and Policy Questions for Improving Exchange Coverage for Children
/in Policy Blogs, Reports CHIP, CHIP, Chronic Disease Prevention and Management, Eligibility and Enrollment, EPSDT, Essential Health Benefits, Health Coverage and Access, Healthy Child Development, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health /by Anita CardwellIf federal funding is not extended for the Children’s Health Insurance Program (CHIP) beyond September 2017, some children may need to transition to exchange coverage. NASHP’s new brief examines potential options and policy questions for improving exchange coverage for children in terms of both affordability and pediatric benefit adequacy. NASHP convened a group of stakeholders including […]
Treatment for Children with Autism Spectrum Disorders and the EPSDT Benefit
/in Policy Reports Behavioral/Mental Health and SUD, Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Health System Costs, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Barbara WirthState Medicaid agencies are working to provide comprehensive health care services for children with autism spectrum disorder (ASD), currently the fastest growing developmental disability in the United States for individuals under age 21. This brief highlights information from the 2014 CMS Informational Bulletin providing clarification on services to be provided to Medicaid-eligible children with ASD […]
State Financing and Delivery Innovations to Address Disparities in Uncontrolled Childhood Asthma
/in Policy Charts Behavioral/Mental Health and SUD, Care Coordination, CHIP, CHIP, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Health System Costs, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Safety Net Providers and Rural Health /by Taylor Kniffin and Felicia HeiderThe high prevalence of uncontrolled asthma among child populations served by Medicaid programs and the associated rising costs often are the impetus for states to improve the quality of care provided to children with asthma. New opportunities to comprehensively address asthma and its triggers are emerging through state and national health care delivery system and […]
The Nuts and Bolts of Medicaid Reimbursement for Developmental Screening: Insights from Georgia, Minnesota, and North Carolina
/in Policy Georgia, Minnesota, North Carolina Reports CHIP, Chronic Disease Prevention and Management, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health /by Najeia Mention and Felicia HeiderThe early years of a child’s life are critical for growth and development. Identifying developmental delays early and providing appropriate referral and treatment can help prevent more severe issues as well as considerable costs. State Medicaid agencies can play an important role in promoting early identification of developmental delays by reimbursing and tracking the use […]
Early Highlights of What the Final Managed Care Rule for Medicaid and CHIP Could Mean for Children with Chronic and Complex Health Care Needs
/in Policy Blogs Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Population Health /by Karen VanLandeghem and Tamara KramerLast week the Centers for Medicare and Medicaid Services (CMS) released its long-awaited final rule outlining requirements for managed care organizations in Medicaid and Children’s Health Insurance Programs (CHIP). Preliminary NASHP analyses indicate that the final rule provides states with significant flexibility in making changes designed to modernize these federal programs as part of health […]
State Strategies for Defining Medical Necessity for Children and Youth with Special Health Care Needs
/in Policy Reports Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by NASHP and Barbara WirthMedicaid programs nationwide are mandated to use the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit to improve the health of low-income children with special physical, emotional, and developmental health care needs. This benefit supports children and youth with special health care needs (CYSHCN) by ensuring they receive individualized health care when they need it—provided those services are deemed medically […]
Using the Bright Futures Guidelines to Promote Preventive Care for Children
/in Policy Blogs CHIP, Eligibility and Enrollment, EPSDT, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care /by NASHPStates have made great strides in enrolling and retaining children in health coverage over the past several years. However, once enrolled, children do not always access screenings and preventive services. A missed well-child visit or a skipped developmental screening can result in undiagnosed and untreated medical issues that when discovered can be costly to treat. […]
Cross-Systems Collaboration: Working Together to Identify and Support Children and Youth with Special Health Care Needs
/in Policy Webinars Children/Youth with Special Health Care Needs, CHIP, Chronic and Complex Populations, Eligibility and Enrollment, EPSDT, Essential Health Benefits, Health Coverage and Access, Healthy Child Development, Integrated Care for Children, Maternal, Child, and Adolescent Health, Safety Net Providers and Rural Health /by NASHPTuesday, March 3, 2015: Multiple state agencies and organizations are working to identify and support children with special physical, emotional and developmental disabilities. Coordination and collaboration across systems, including the sharing of data, increases the ability for states to identify children at risk and ensure they are receiving the appropriate health, mental health and developmental services. This webinar features three states discussing collaborations across state programs that impact the identification and treatment of children in need of specific services.
Promoting Developmental Screening in the First Three Years of Life: Lessons from Illinois
/in Policy Webinars Eligibility and Enrollment, EPSDT, Healthy Child Development, Maternal, Child, and Adolescent Health /by NASHPThursday, February 26, 2015: The webinar focused on the value of developmental screenings for children and the Developmental Screening measure of the Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP. Participants heard about Illinois’ efforts to use policy levers to engage providers in developmental screening, and how the measure is used within the State; and federal efforts to promote the performance and measurement of developmental screenings, and upcoming opportunities for technical assistance.
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
Through Coordination and Investment, Arizona Substantially Increases Access to School-Based Behavioral Health Services
/in COVID-19 State Action Center, Policy Arizona Blogs, Featured News Home Back to School, Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, COVID-19, EPSDT, Health Equity, Integrated Care for Children, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Social Determinants of Health /by Anita Cardwell and Gia GouldBy leveraging federal Medicaid funding and state investment while simultaneously clarifying complex billing procedures and enhancing engagement with providers, Arizona has made remarkable progress in increasing student access to critical school-based behavioral health services. Arizona’s efforts to improve school behavioral health services began in 2018 when its state legislature allocated $3 million from the state’s […]