The 2010 Maternal and Child Health Update presents 2010 data gathered from U.S. states and territories in the annual maternal and child health survey conducted by the National Governors Association Center for Best Practices
Medicaid and the Children’s Health Insurance Program (CHIP) provide health insurance coverage to over 60 million low-income children, their parents, and pregnant women. With the passage of recent federal legislation—namely, The Affordable Care Act enacted in March 2010–states now have new program options for enrollees with publicly funded coverage.
The 2010 Maternal and Child Health Update presents 2010 data gathered from U.S. states and territories in the annual maternal and child health survey conducted by the National Governors Association Center for Best Practices (NGA Center). This year’s survey reflects the changing environment resulting from difficult budget situations and health reform, and focuses on initiatives that states have undertaken to improve care management and provide higher quality and more effective care. Key findings among the states and territories include the following:
- Medical homes programs are increasingly used to coordinate care for children. Twenty-one of the 41 states that responded to the 2010 survey have established a medical home program that enrolls large segments of the child Medicaid/CHIP population. Various methods are used by states to pay providers in medical home programs: fee-for-service, fee-for-service with a bonus payment, and managed care capitation payment (Table 1).
- Managed care is the predominant means of delivering Medicaid services to children. Twenty-seven of the 41 states that responded to the survey are using managed care to deliver Medicaid services to children, with two-thirds or more of children enrolled in many of the states. Seventeen states mandate enrollment of special needs children into their managed care programs (Table 2).
- Payment reform is becoming a focus for improving care delivery and coordination for children. States that responded to the survey indicated that they are most interested in payment reforms that include pay-for-performance, accountable care organizations, and emergency room prevention incentives, as ways of improving care delivery (Table 3).
The Affordable Care Act enacted by Congress in March 2010 authorized funding for the expansion of home visitation programs. These programs are a major maternal and child health initiative, giving states grant opportunities to expand evidence-based programs for at-risk children. States responding to the survey reported varying qualifications for home visitation, ranging from age limits for eligibility and enrollment prioritization criteria based on variety of factors including age of mother, marital status, income, and history of abuse (Table 4).
The survey instrument for the 2010 Maternal and Child Health Update was developed by the NGA Center and designed to include data points on emerging issues relevant to maternal and child health populations. The survey was sent individually to all 50 states and the five U.S. territories in August 2010. Responses were received from 41 states and territories in the fall of 2010. The current status of any program may have changed since the collection of data.