As we move to managed care models for delivering services to all consumers eligible for Medicaid, the needs of special populations is a big concern. That is the case with foster children – who rely on Medicaid for their health care coverage and have very specific needs. How to make managed care work for foster children? That was focus of the presentation, Serving The Behavioral Health Needs Of Children In Foster Care Through Medicaid Managed Care, at the 2014 OPEN MINDS Planning & Innovation Institute, featuring Patricia Wilson, Consultant, Foster Care, Radmacher Wilson, Inc. and Cindy Downey, Community Relations Manager, Foster Care, Cenpatico.
What are those unique needs of foster children? Foster children experience high levels of trauma, transiency, psychotropic medication use, and higher rates of hospitalization and readmissions. They are also subject to more “touch points,” interacting with foster families, biological and kinship relations, medical consenters, child protective services, judges, health care providers, child placing agencies, and advocacy groups, to name a few.
What are the optimal state system design elements to make managed care work for foster children? The speakers identified five key factors:
- Complex care management
- Psychotropic medication review
- Stakeholder engagement and training with a focus on a trauma-informed lens for services
- Addressing and planning for geographical differences
- Performance-based payment, are all parts of the equation
In their closing, Ms. Waldron and Ms. Downey encouraged state and county officials to be sure to consider the unique, high needs of foster children – and to engage with child welfare, Medicaid, and behavioral health agencies before redesigning Medicaid benefits for this population.
For more on this topic, check out these news stories from OPEN MINDS:
- Florida Medicaid To Launch Child Welfare Specialty Plan Enrollment In May 2014
- New York State Moving Children In Foster Care From FFS Medicaid To Managed Care
- Georgia Selects Amerigroup As Medicaid MCO For Children In Child Welfare System
- Georgia Transitions Children In Foster Care To Specialized Medicaid Managed Care Plan
Or, check out these resources in our Industry Library:
- Managed Care In Child Welfare – An Encore
- Planning To Serve Foster Children In Managed Care
- Treating The Whole Child
- Big Changes In Federal Child Welfare Funding
The issue of how to customize managed care for specific populations is a huge need for consumer groups, and the driver behind the new vertical managed care models that are consumer-specific. Look for more of this in the future.