Introduction: To improve services and assure predictable costs of care for Children and Youth with Special Health Care Needs (CYSHCN), state Title V and Medicaid programs are cooperating to reconceive care systems including contracting arrangements with managed care organizations (MCOs). This article describes how a consensus-based framework, the National Standards for Systems of Care for CYSHCN, influenced the redesign of two state Medicaid managed care programs: a statewide managed care plan for children with medical complexity in Florida and a regional accountable care program serving children and adults in Colorado.
Methods: Data are drawn from a recent evaluation of the National Standards, which define the core components of a comprehensive, coordinated, and family-centered system of care for CYSHCN. The authors synthesized insights from documents and semi-structured interviews with national and state stakeholders.
Results: The states used the National Standards in different ways. Florida translated the Standards into contract provisions and holds its MCO accountable to performance targets specific to CYSHCN. In Colorado, the Standards had an indirect influence on contract provisions with regional accountable entities (RAEs) and the state's oversight of EPSDT, which helps ensure that RAEs meet their obligations to CYSHCN. Managed care leaders viewed the Standards as an impetus to sharpen quality improvement and foster whole-person care.
Discussion: The National Standards offer a flexible framework to help states design Medicaid managed care programs and improve systems of care for CYSHCN. States can learn from one another's experiences applying the Standards in the context of their policy environments.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1007/s10995-022-03499-y | DOI Listing |
Circ J
January 2025
Department of Frontier Cardiovascular Science, Graduate School of Medicine, The University of Tokyo.
Background: Comprehensive management of acute coronary syndrome (ACS) requires seamless treatment across institutions, including intensive care centers and local clinics. However, maintaining guideline-directed medical therapy remains challenging. One promising option to improve the situation may be the implementation of regional collaborative clinical pathways.
View Article and Find Full Text PDFTransplant Cell Ther
January 2025
The University of Chicago Medical Center, Chicago IL.
Background: Chimeric Antigen Receptor T-cell (CAR-T) therapy has revolutionized the treatment landscape for various hematological malignancies. However, it is associated with a range of hematologic complications, including severe and often prolonged thrombocytopenia. Currently, there are no known effective preventative or management measures against CAR-T-induced thrombocytopenia.
View Article and Find Full Text PDFAust Crit Care
January 2025
School of Nursing, The University of Auckland, Auckland, New Zealand; Cardiothoracic and Vascular Intensive Care Unit, Te Whatu Ora Te Toka Tumai Auckland, Auckland, New Zealand. Electronic address:
Background: Clinical practice guidelines endorse family involvement in ward rounds to improve communication and engagement between patients, whānau (family), and healthcare teams, yet the practice has not been universally implemented. Whānau inclusion in adult bedside rounds is often met with hesitation by intensive care unit (ICU) healthcare clinicians, and reasons for this have not been explored in Aotearoa, New Zealand.
Objectives: The aim of this study was to assess attitudes and perceptions of ICU clinicians towards whānau-family inclusion in adult ICU ward rounds in Aotearoa New Zealand.
Pituitary
January 2025
Division of Endocrinology, Santiago de Compostela University and Ciber OBN, Santiago, Spain.
Purpose: A recent update of consensus guidelines for the management of Cushing's disease (CD) included indications for medical therapy. However, there is limited evidence regarding their implementation in clinical practice. This study aimed to evaluate current medical therapy approaches by expert pituitary centers through an audit conducted to validate the criteria of Pituitary Tumors Centers of Excellence (PTCOEs) and provide an initial standard of medical care for CD.
View Article and Find Full Text PDFNiger Med J
January 2025
Department of Obstetrics and gynecology, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria.
Abdominal ectopic pregnancy is a rare type of ectopic pregnancy associated with high maternal and perinatal mortality. We present a case of a 28-year-old now primipara who was misdiagnosed to have abruptio placentae and ruptured uterus on two different occasions from a primary health care center but was found to have an advanced abdominal ectopic gestation at 21 weeks gestational age. The patient was managed by exploratory laparotomy and is currently doing well.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!