Health Care Reform Tracking Project: The Promising Approaches Series
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finance, behavioral health, managed care, systems of care, system of care
Beginning in 1995, the Health Care Reform Tracking Project (HCRTP) tracked publicly-financed managed care initiatives and their impact on children with mental health and substance abuse (i.e., behavioral health) disorders and their families. Drawing on the findings, a series of papers, Promising Approaches for Behavioral Health Services to Children and Adolescents and Their Families in Managed Care Systems, highlights relevant issues and approaches that have surfaced through the HCRTP’s all-state surveys and in-depth impact analyses in a smaller sample of 18 states. The papers, available below, focus on a specific aspect of publicly-financed managed care systems and are intended to be technical assistance resources for states and communities as they refine their systems to better serve children and families.
Series #1: Managed Care Design & Financing describes seven managed care design and financing approaches that were identified through the HCRTP as incorporating features that support effective service delivery for children and adolescents with behavioral health disorders and their families. They include three statewide approaches focused on a total population of children and four local approaches focused on subsets of the total population. The paper concludes with a summary of common challenges and characteristics across approaches. The paper also includes a list of resource contacts.
Series #2: A View from the Child Welfare System presents information to consider when designing public managed care to meet the behavioral health needs of children and families involved with the child welfare system. It also presents examples of promising approaches from four states and communities and offers concluding observations and summarizes challenges faced by the states and communities, as well as similar key strategies noted across the four sites.
Series #3: Making Interagency Initiatives Work for Children and Families in the Child Welfare System highlights the premise of interagency initiatives and the promise that such initiatives have for children and families involved with the child welfare system when child welfare in an active partner in planning, implementation, and evaluation. The paper also describes the study methodology, including steps used to identify and select the three interagency initiatives featured, and highlights similarities, differences, and challenges shared by the three initiatives in accommodating the child welfare system and the needs of children and families served by the system. The summary includes advice from the study respondents to other states and communities and offers recommendations for the future.
Series #4: Accountability and Quality Assurance in Managed Care Systems identifies a number of managed care accountability and quality assurance approaches that support effective service-delivery to children with serious emotional problems and their families. These promising approaches include both statewide approaches focused on a total population and local sites focused on a specific geographical area. The paper addresses four areas of accountability: (1) availability of data for decision making, (2) types of system performance information collected and tracked, (3) measurement of clinical and functional outcomes, and (4) quality measurement. The final section for each issue summarizes the common characteristics and challenges described by key stakeholders and provides recommendations to other states and communities. The paper concludes with a list of resource contacts for the promising approaches, and a list of national organizations addressing these issues.
Series #5: Serving Youth with Serious and Complex Behavioral Health Needs in Managed Care Systems begins with a brief discussion of the issues and challenges related to serving youth with serious and complex behavioral health disorders and their families in the context of managed care. These issues and challenges have surfaced through all of the previous activities of the Tracking Project. A number of promising approaches for meeting the needs of this population are then described. Identified through the state surveys and impact analysis that have comprised the Tracking Project, these approaches are perceived by key state and local informants to support effective service delivery to this most challenging population.
Series #6: Family Involvement in Managed Care Systems This paper addresses five areas of family involvement within managed care systems: (1)Requirements for Family Involvement; (2) Family Involvement at the System Management Level; (3) Family Involvement at the Service Delivery Level; (4) Practice of Relinquishing Custody to Obtain Services; and, (4) Program and Staff Roles for Families and Youth. Issues and challenges on these five areas are addressed, as well as promising approaches and features. The final section summarizes the commonalities across the promising approaches and strategies described by key stakeholders. It concludes with a list of resource contacts and a list of national organizations addressing these issues.
Series #7 Care Management in Public Sector Managed Care Systems This monograph focuses on promising approaches in care management for children with serious emotional problems enrolled in a managed care system and their families. The volume begins with a brief discussion of the issues and challenges related to care management within a managed care framework that have been identified through previous activities of the Tracking Project. A number of promising approaches for care management are then described. Identified through the state surveys and impact analyses of the Tracking Project, these approaches are perceived by key state and local informants to support effective care management systems.
Series #8 Clinical Decision Making Approaches Purpose Driven by a combination of factors, including broader dissemination of clinical research, expanded family and consumer voice, consent decrees, media reports and escalating health care costs, state regulatory and fiscal managers have taken on a greater role in oversight of child and adolescent behavioral health care delivery. This study examines various clinical decision making approaches that a sampling of states or management entities within states are utilizing for child and adolescent behavioral health service delivery within a managed care environment. It profiles a representative sample of 2 states and/or local managed care entities (MCE) that are using formal clinical decision making protocols, guidelines, and/or processes to inform decisions about the services and supports provided to children and adolescents with behavioral health disorders and their families.
The HCRTP was co-funded by the National Institute on Disability and Rehabilitation Research in the U.S. Department of Education and the Substance Abuse and Mental Health Services Administration in the U.S. Department of Health and Human Services. Supplemental funding was provided by the Administration for Children and Families of the U.S. Department of Health and Human Services, the David and Lucile Packard Foundation and the Center for Health Care Strategies, Inc. to incorporate a special analysis related to children involved in the child welfare system. The HCRTP was conducted jointly by the Research and Training Center for Children's Mental Health at the University of South Florida, the Human Service Collaborative of Washington, DC and the National Technical Assistance Center for Children's Mental Health at Georgetown University.
See individual reports for citations.