1 / 17

Improving Financing of Care for CYSHCN

Improving Financing of Care for CYSHCN. Deborah Allen, ScD The Catalyst Center. The prevailing wisdom. As long as you make sure they have coverage, CYSHCN will be okay Especially given: Title V Early intervention IDEA Medicaid TEFRA/HCBS waiver programs SSI. So….

unity
Download Presentation

Improving Financing of Care for CYSHCN

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Improving Financing of Care for CYSHCN Deborah Allen, ScD The Catalyst Center

  2. The prevailing wisdom • As long as you make sure they have coverage, CYSHCN will be okay • Especially given: • Title V • Early intervention • IDEA • Medicaid TEFRA/HCBS waiver programs • SSI

  3. So… There can’t be any real “financing problem” for children and youth with special health care needs

  4. Not Quite • Yes, most children with special health care needs have health care coverage* • If low income, covered by Medicaid • At higher income, covered by private insurance • If disabilities are severe, may be covered under TEFRA or Medicaid HCBS waiver program • But…. *Although in Michigan, almost 7% actually lacked coverage at some point in 2005-6

  5. Nationally, over 18% of families reported financial problems in 2005-6

  6. And in Michigan • Almost 20% of families spent more than $1000 on expenses for CYSHCN in 2005-6 • Up from 8% in 2001 • And 16% of families reported hardship related to the cost of their children’s care

  7. A minimum estimate of cumulative MI family expenditure

  8. Family Employment and Income • From National CYSHCN Survey • 1/4 of families nationally reported that having a CYSHCN affected family employment • In Michigan, it’s over 25% -- higher than the national rate • From National Longitudinal Survey of Youth • Mothers of children with disabilities earn less than other mothers • Families of children with disabilities earn less and have a lower net worth than other families • Families of children with disabilities reported net assets $36,000 below other families

  9. When families are the payer of last resort: • Family debt, bankruptcy • Children do not receive needed services • Other family members are affected – less funds for food, clothing, housing, education • Marital/family stress

  10. Pathways to Hardship • High expenses for items unique to families of CYSCHN • Higher expenses for items every family needs • Loss of employment income

  11. Catalyst Center strategy • Define and document “the problem” • Expand coverage • Reduce underinsurance • Promote funding for needs that are outside the realm of health insurance • Promote funding for infrastructure

  12. Define and document the problem • Disseminate available research findings • Develop, pilot and promote new medical debt survey instrument • How does debt affect families • Capture and publicize family stories • Capture national picture • Capture state picture

  13. Expand coverage • Provide TA to states around Medicaid expansion option under FOA • Recognize what it can and can’t do • How is FOA different from a waiver • What are the limits on FOA • Estimate the cost • Based on realistic estimates of uptake • Learn from other states • Publicize innovative coverage strategies via Chartbook

  14. Address underinsurance and costs that are outside the realm of insurance • FOA is relevant here too • Provide TA to states on Catastrophic Illness Relief • Creating political will • Understanding day-to-day operations • Documenting costs and benefits • Publicize innovative financing strategies via Chartbook

  15. Fund infrastructure • Provide TA to states re expansion of care coordination • To cover whole state • To cover CYSHCN defined broadly • Components of TA • Help in defining the nature of the service • Help in identifying funding options • Help in predicting cost • What determines cost • Who does it • Caseload • System costs • Publicize innovative financing strategies via Chartbook

  16. Collaboration with the Catalyst Center • Use the Chartbook • Help us review medical debt instrument • Help us collect family stories • Collect stories at the state level • Pursue Medicaid buy-in option • Work with us to expand resources for care coordination

  17. Find out more http://www.hdwg.org/catalyst/

More Related