Medicaid and CHIP: Reports for Monitoring Children's Health Care Services Need Improvement

PDF Version Also Available for Download.

Description

Correspondence issued by the Government Accountability Office with an abstract that begins "Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for low-income families and children--play a critical role in addressing the health care needs of children. In 2008, more than 36 million children in the United States received health care coverage through Medicaid or CHIP. Like all children, children covered by Medicaid and CHIP may have health care conditions that could warrant care from primary care or specialist providers. At the same time, a significant number of children in Medicaid and CHIP may not be ... continued below

Creation Information

United States. Government Accountability Office. April 5, 2011.

Context

This text is part of the collection entitled: Government Accountability Office Reports and was provided by UNT Libraries Government Documents Department to Digital Library, a digital repository hosted by the UNT Libraries. More information about this text can be viewed below.

Who

People and organizations associated with either the creation of this text or its content.

Provided By

UNT Libraries Government Documents Department

Serving as both a federal and a state depository library, the UNT Libraries Government Documents Department maintains millions of items in a variety of formats. The department is a member of the FDLP Content Partnerships Program and an Affiliated Archive of the National Archives.

Contact Us

What

Descriptive information to help identify this text. Follow the links below to find similar items on the Digital Library.

Description

Correspondence issued by the Government Accountability Office with an abstract that begins "Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for low-income families and children--play a critical role in addressing the health care needs of children. In 2008, more than 36 million children in the United States received health care coverage through Medicaid or CHIP. Like all children, children covered by Medicaid and CHIP may have health care conditions that could warrant care from primary care or specialist providers. At the same time, a significant number of children in Medicaid and CHIP may not be receiving basic preventive care, which these programs generally cover. For example, we reported in 2009 that, on the basis of parents' reports in national surveys, about 40 percent of children in Medicaid and CHIP had not had a well-child checkup over a 2-year period. Many state Medicaid and CHIP programs and other health care purchasers have started initiatives to improve care coordination for children and provide children with access to networks of care. For the purposes of this report, care coordination is broadly defined as a process in which an individual or group helps to arrange a patient's primary and specialty health care services. Care coordination can be provided by primary care providers or through other individuals such as social workers or case managers. Care coordination activities can include communication--sharing information among participants in a patient's care--and linking patients to community resources. Care coordination can help children gain access to a network of care, that is, a set of providers who are available to help address the primary and specialty health care needs of a patient. The Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), oversees state Medicaid and CHIP programs at the federal level and collects annual reports. States are required, under federal law, to annually report to CMS on the provision of a range of preventive, diagnostic, and treatment services for eligible children, known as Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services. States generally provide Medicaid and CHIP services through two service delivery and financing models--fee-for-service and managed care. Under a fee-for-service model, states pay providers for each covered service for which the providers bill the state. Under a managed care model, states contract with managed care plans, such as health maintenance organizations, to provide or arrange for medical services, and prospectively pay the plans a fixed monthly fee per enrollee. Concerns have been raised about delivery model incentives and health care service utilization. In contrast, because providers are paid for each covered service provided in fee-for-service models, there may be an incentive to provide more services to beneficiaries than necessary. As a result, interest in understanding access to, and use of, services by delivery model in Medicaid and CHIP has been long-standing. In the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Congress required that we study Medicaid and CHIP children's access to primary and specialty care, including the extent to which care coordination is provided for children's care in Medicaid and CHIP and information on children's access to networks of care. In addition, Congress required that we study, as appropriate, information on the degree of availability of services for children in Medicaid and CHIP. This report examines 1) the extent to which children in Medicaid and CHIP receive care coordination and have access to networks of care, 2) how selected states are coordinating care for children in Medicaid and CHIP, and 3) the extent to which required state reports collected by CMS provide information on the provision of services to children in Medicaid and CHIP."

Subjects

Language

Item Type

Identifier

Unique identifying numbers for this text in the Digital Library or other systems.

Collections

This text is part of the following collection of related materials.

Government Accountability Office Reports

The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for the U.S. Congress investigating how the federal government spends taxpayers' money. Its goal is to increase accountability and improve the performance of the federal government. The Government Accountability Office Reports Collection consists of over 13,000 documents on a variety of topics ranging from fiscal issues to international affairs.

What responsibilities do I have when using this text?

When

Dates and time periods associated with this text.

Creation Date

  • April 5, 2011

Added to The UNT Digital Library

  • June 12, 2014, 7:50 p.m.

Usage Statistics

When was this text last used?

Yesterday: 0
Past 30 days: 1
Total Uses: 8

Where

Geographical information about where this text originated or about its content.

Place Name

Publication Place

Map Information

  • map marker Automatically generated Place Name coordinates.
  • map marker Automatically generated Publication Place coordinates.
  • Repositioning map may be required for optimal printing.

Mapped Locations

Interact With This Text

Here are some suggestions for what to do next.

Start Reading

PDF Version Also Available for Download.

International Image Interoperability Framework

IIF Logo

We support the IIIF Presentation API

United States. Government Accountability Office. Medicaid and CHIP: Reports for Monitoring Children's Health Care Services Need Improvement, text, April 5, 2011; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc298632/: accessed November 18, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.