Paterson also said the company believes it can’t provide quality health care without looking at the children’s social needs. The plan allocates about $150 per child, to be spent at the care manager’s discretion, for items such as a baseball glove for a kid who wants to try out for a team or a new dress for a girl who wants to go to a school dance.
The idea is to close some of the gaps in care that often occur with children in foster care. When children have been moved around, “it’s hard to put the pieces of the puzzle together,” says Dr. Moira Szilagyi, chairwoman of the National Council on Foster Care, Adoption and Kinship Care for the American Academy of Pediatrics.
“If a provider has not stepped back and looked at the larger history of abuse, multiple families, needs being neglected, they may put children on medication that may or may not benefit the child,” Szilagyi said. “They may not see it’s the impact of childhood trauma.”
“(Foster children) can be a fluid population in terms of providing adequate services to them,” said David A. Rogers, assistant deputy secretary for Medicaid. “There’s a uniqueness there that makes them a good target population” for managed care.
Szilagyi said she’s had patients who come in with five or six different diagnoses. Once doctors understand the children’s backgrounds better, they’re often able to get them the right mental health services.
She emphasized the importance of preventive care. “If you’re not getting preventive care, then you’re not getting your other needs met.”
Sara Rosenbaum, a health law and policy professor at George Washington University, said many states are interested in doing more managed care programs for at-risk populations.
“In some ways, insurers who specialize or have an expertise in care of high-needs populations may have less risk (caring for them)...it’s not to say there aren’t any risks, but with the general population, you don’t know whether there’s going to be unanticipated risks.” Specialists are more likely to know what to expect, she said.
Tue, Feb 11 2014