MCHPRC: Publications

	Publications

Medicaid SCHIP Private Health Insurance Managed Care Children with Special Health Care Needs Adolescents Children's Health Service Delivery Pediatric Provider Capacity Program Impact Series Join Our Email List

Adolescents

Reports:

Eligibility, Benefits, and Cost-sharing in Separate SCHIP Programs
by Harriette B. Fox, Ruti G. Levtov, and Margaret A. McManus. Report, 34 pages, October 2003, $40.
This report describes eligibility, benefit, and cost-sharing policies in 36 separate SCHIP programs. Detailed state tables are included on SCHIP and Medicaid income eligibility levels, SCHIP benefit policies, and premium, copayment, and coinsurance amounts. The information is based on an analysis of state plan documents, managed care contracts, and provider and member manuals, as well as telephone interviews and email correspondence with state SCHIP agency staff.

Is the Health Care System Working for Adolescents? Perspectives from Providers in Boston, Denver, Houston, and San Francisco
by Margaret A. McManus, Kandi I. Shejavali, and Harriette B. Fox. Report, 40 pages, October 2003.
This report provides a comprehensive assessment of how well adolescents in four urban areas are being served by the current health care system. It contains provider perspectives on the extent to which preventive and primary care, reproductive care, and behavioral care adequately meet adolescents’ needs and the main organizational, health insurance, managed care, and other factors facilitating or impeding access to these services. The report also includes recommendations for organizing and financing an optimal health care system for adolescents. Information was obtained primarily from on-site interviews with health care providers.
Download a free pdf of this report.

Private Health Insurance for Adolescents: Is It Adequate?
by Harriette B. Fox, Margaret A. McManus, and Mary B. Reichman. Report, 28 pages, September 2002, $40.00.
This report examines the extent of private health insurance coverage available for services required by six hypothetical adolescents with different health conditions: asthma, attention deficit hyperactivity disorder, injury, major depressive disorder, pregnancy with STD, and substance abuse with bipolar disorder. The analysis considers the availability of the benefit, access restrictions and protections relevant to the adolescent´s condition, and limits in amount and duration of coverage. Information for the study was obtained from contract documents for the most commonly sold HMO and PPO product in each state.

Access to Care for S-CHIP Adolescents
by Harriette B. Fox, Margaret A. McManus, and Stephanie J. Limb. Report, 45 pages, December 2000. Available from the Kaiser Family Foundation (1-800-656-4533; package code 2243).
This report examines S-CHIP implementation issues and challenges affecting access to care by adolescents in five states (California, Connecticut, Maryland, Missouri, and Utah). The report describes special S-CHIP contract provisions pertaining to adolescents and examines provider network availability, service coverage, and access to primary care, dental care, family planning services, and mental health services. Also included in the analysis are issues pertaining to the use of health risk assessments, cost-sharing, and confidentiality. Detailed tables on benefits and cost-sharing requirements and a description of each state´s program are provided. Information was obtained primarily through on-site interviews with S-CHIP officials, managed care organization officials, providers and families.
Download a free pdf of this report.

Using Medicaid to Finance Care Coordination Services for Children and Adolescents with Severe Emotional Disorders
by Harriette B. Fox and Lori B. Wicks, Technical Report, 80 pages, 1991, $25.00.
This report identifies the ways in which Medicaid can be used to finance care coordination services furnished to children and adolescents with severe emotional disorders. It presents information about basic Medicaid program requirements that pertain to coverage of care coordination services, describes six options for Medicaid financing of various care coordination activities, and assesses the pros and cons of each option with regard to youth having severe emotional disorders. The report also describes five model care coordination systems and indicates the extent to which Medicaid could be used to finance each one.

Medicaid Financing for Mental Health and Substance Abuse Treatment Services for Children and Adolescents
by Harriette B. Fox, Lori B. Wicks, Margaret A. McManus, and Rebecca W. Kelly, Technical Report, 69 pages, May 1990, $25.00.
This report provides an assessment of the ways in which the Medicaid program can be used to finance many components of treatment for children and adolescents with mental health or substance abuse problems. The report provides an overview of the state role in developing Medicaid eligibility and service benefit policies, provides detailed information on Medicaid coverage policies in each state, and discusses opportunities for covering mental health and substance abuse treatment services under the various Medicaid benefit categories.

Articles:

Private Health Insurance for Adolescents: Is it Adequate?
By Harriette B. Fox, Margaret A. McManus, and Mary B. Reichman. Journal of Adolescent Health. Vol. 32, no. 6, pp.12-24, supplement to June 2003.
This article examines the extent of private health insurance coverage available for services required by six hypothetical adolescents with different health conditions: asthma, attention deficit hyperactivity disorder, injury, major depressive disorder, pregnancy with STD, and substance abuse with bipolar disorder. The analysis considers the availability of the benefit, access restrictions and protections relevant to the adolescent’s condition, and limits in amount and duration of coverage. Information for the study was obtained from contract documents for the most commonly sold HMO and PPO product in each state.

Early Assessments of SCHIP’s Effect on Access to Care for Adolescents
by Harriette B. Fox, Margaret A. McManus, and Stephanie J. Limb
Journal of Adolescent Health. Vol. 32, no.6, pp. 40-52, supplement to June 2003.
This article examines implementation issues and challenges affecting access to care for adolescents during the first year of SCHIP operation in five states (California, Connecticut, Maryland, Missouri, and Utah).