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USING MANAGED CARE CONTRACTS TO PROMOTE CHILD HEALTH:

A Report on the 2004 State Advanced Leadership Workshops on Fiscally Sound Medicaid and SCHIP Managed Care Contracts for State Title V Maternal and Child Health Agencies And Local Health Departments

 

Adobe Acrobat pdf Printer-Friendly Report (640KB)

Medicaid, MCOs, SCHIP, TitleV

Acknowledgements

This document was produced by the U.S. Department of Health and Human
Services, Health Resources and Services Administration, Maternal and Child
Health Bureau under contract to the George Washington University Center for
Health Services Research and Policy and Johnson Group Consulting Inc.

I. Introduction

Since 2000, the Center for Health Services Research and Policy at The George Washington
University (GWU), has undertaken a series of projects based on the Medicaid managed care
contracts studies and the managed care purchasing specifications. Specifically, GWU
researchers developed Medicaid Pediatric Purchasing Specifications and Children with Special
Health Care Needs Purchasing Specifications with funding from the Health Resources and
Services Administration (HRSA) and the Commonwealth Fund, among others. These purchasing
specifications offer suggested model contract language options for States to use in drafting
managed care agreements.

In 2001, GWU worked with HRSA’s Maternal and Child Health Bureau (MCHB) to host a
workshop in Little Rock, Arkansas, for teams of State and local officials from six States. The
team members represented Medicaid, State Children’s Health Insurance Programs (SCHIP), Title
V, and local public health agencies. This successful team approach became the model for a
series of State-specific “leadership” workshops, designed to address similar issues as the Little
Rock workshops with the advantage of being able to provide tailored technical assistance.

In 2004, five States responded to the offer for technical assistance related to child health and
used the workshops as an opportunity to focus on particular challenges. HRSA’S MCHB and the
Managed Care and Health Services Financing Technical Assistance Center (MCTAC), John
Snow, Inc. co-sponsored this workshop series. For each workshop, Jeff Levi of GWU and Kay
Johnson of Johnson Group Consulting provided faculty support. James Resnick of HRSA’S
MCHB attended each workshop. A leadership group – including a minimum of leaders from
Medicaid, SCHIP, Title V and local public health – was assembled in each State to plan,
convene, and attend the workshop.

Each workshop involved collaboration among Federal sponsors, private-sector faculty, and State
leaders. The role of HRSA’S MCHB and MCTAC in co-sponsoring the workshops was to:
identify the faculty to conduct the workshop, pay for the honorarium and travel expenses of the
faculty, and coordinate with Maternal and Child Health leaders and faculty to customize the
workshop to a State’s particular Medicaid/SCHIP concerns. State-level co-sponsors were
responsible for arranging and paying for the following activities: 1) promoting the workshop,
including the development, printing, and mailing of the promotional materials, 2) sending
invitations to the target audience, 3) securing meeting space, audiovisual equipment, and the
food, if desired, 4) registering attendees, and 5) identifying issues and developing the agenda for
a workshop.

This paper describes the substantive results of these “Advanced Leadership Workshops.” We set
out to offer strategies, tools, and techniques to negotiate fiscally sound managed care contracts
that ensure the delivery of quality maternal and child health services and to provide practical
knowledge and experiential learning about pediatric managed care contracts. The workshop
content included this and more. Several key themes and some promising new ideas emerged.
Most important, perhaps, is how the workshops created an opportunity for dialogue about
maternal and child health issues and challenges. The paper concludes with some “lessons
learned” about the process of engaging States in this technical assistance activity.

Finally, we note that much of what emerged from these workshops is reflected in the briefing
materials prepared with each State during the planning process for their workshop. (See
appendices.) These briefing materials were developed to reflect each State’s issues of concern
and each workshop’s agenda. Readers are encouraged to read and refer to these materials.