The Louisiana Family Opportunity Act Medicaid Buy-in Program

Bachman, Sara S.; Comeau, Meg; Dworetzky, Beth; Hamershock, Rose; Hirschi, Melissa

doi:10.1007/s10995-015-1775-1

Cited by 5 publications

(9 citation statements)

References 16 publications

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“…However, the current study suggests that policy and administrative changes are needed to improve overall satisfaction with this particular Medicaid Buy-In program and strengthen access to care for children with disabilities. While these results are not currently generalizable to other Medicaid Buy-In programs such as the Family Opportunity Act Medicaid Buy-In program, which has income limits (Bachman et al, 2015), the family perspectives presented here may provide a framework for thinking about how Medicaid Buy-In programs can best meet the needs of children with disabilities while providing much-needed financial relief to their families.…”

Section: Discussionmentioning

confidence: 90%

“…There are various approaches to defining ‘access’ to health care ranging from the ability to pay for services to entry into and utilization of services and health-seeking behaviors (Bethell et al, 2008; Davidoff, 2004; Honberg et al, 2005; Kogan et al, 2005; McPherson et al, 1998; Yu et al, 2008). For children with disabilities, who may use a wide array of high-cost health-care and supportive services (Bachman et al, 2015), access to care will vary not only in accordance with diagnosis and severity, but also in a family’s ability to pay for these services (Penchansky and Thomas, 1981).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…Medicaid Buy-In programs can be used to supplement benefits for children whose health-care needs exceed the amount, scope, and duration of services provided by their private insurance. Medicaid Buy-In programs not only represent a way to cover more services for children with disabilities (Bachman et al, 2015) but also help reduce families’ out-of-pocket costs by acting as a secondary payer for deductibles, co-pays, and coinsurance associated with private health insurance.…”

Section: Introductionmentioning

confidence: 99%

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Access to care among children with disabilities enrolled in the MassHealth CommonHealth Buy-In program

Hirschi

Walter

Wilson

et al. 2018

J Child Health Care

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Children with disabilities utilize more health-care services and incur higher costs than other children do. Medicaid Buy-In programs for children with disabilities have the potential to increase access to benefits while reducing out-of-pocket costs for families whose income exceeds Medicaid eligibility. This study sought to understand how parents and caregivers of Massachusetts children with disabilities perceive access to care under CommonHealth, Massachusetts's Medicaid Buy-In program. Parents and caregivers ( n = 615) whose children were enrolled in CommonHealth participated in a survey assessing the impact of the program. Qualitative data were coded across five access domains-availability, accessibility, accommodation, affordability, and acceptability. Data suggest that CommonHealth improves access to care for children with disabilities by providing the benefits that were limited in scope or unavailable through other insurance before enrollment and by making available services more affordable. Policy and administrative changes could improve the program and further increase access to care for children with complex, costly conditions. Adopting a Medicaid Buy-In program may be an effective way for states to create a pathway to Medicaid for children with disabilities whose family income is too high for Medicaid and who have unmet needs and/or whose families incur high out-of-pocket costs for their care.

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Section: Discussionmentioning

confidence: 90%

Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Access to care among children with disabilities enrolled in the MassHealth CommonHealth Buy-In program

Hirschi

Walter

Wilson

et al. 2018

J Child Health Care

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“…A majority of the 15 studies (n = 8) used a cross-sectional research design, and collected or analyzed one wave of data (e.g., Bachman et al, 2015;Cook et al, 2004;Nebbitt et al, 2014). One study used a longitudinal design to collect 17 waves of annual data over a 17-year study period (Gavin et al, 2011), and six studies used two waves of data (e.g., pre-and post-test design) to examine the relationship between welfare participation and depression over time (e.g., Knab et al, 2006;Pande, 2014;Sullivan & Decoster, 2001).…”

Section: Characteristics Of Research Data and Study Designsmentioning

confidence: 99%

“…Of the 15 reviewed reports, five studies reported multiple welfare programs (e.g., Medicaid, SSI, AFDC, TANF, or WIC; Bachman et al, 2015;Buckner et al, 1999;Cook et al, 2004;Dosreis et al, 2001;Knab et al, 2006). Two studies focused on a general concept of welfare (e.g., any types of welfare programs; Go, 1999;Rhee et al, 2005).…”

Section: Welfare Programsmentioning

confidence: 99%

Welfare participation and depression among youth in the United States: A systematic review

Fraser

et al. 2018

Children and Youth Services Review

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Financing Care for CYSHCN in the Next Decade: Reducing Burden, Advancing Equity, and Transforming Systems

et al. 2022

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Blueprint for Change: Guiding Principles for a System of Services for CYSHCN and Their Families (Blueprint for Change), presented by the Maternal and Child Health Bureau at the Health Resources and Services Administration, outlines principles and strategies that can be implemented at the federal and state levels and by health systems, health care providers, payors, and advocacy organizations to achieve a strong system of care for children and youth with special health care needs (CYSHCN). The vision for the financing of services outlined in the Blueprint for Change: Guiding Principles for a System of Services for CYSHCN and their Families is one in which health care and other related services are accessible, affordable, comprehensive, continuous, and prioritize the wellbeing of CYSHCN and their families. There are several barriers caused or exacerbated by health care financing policies and structures that pose significant challenges for families of CYSHCN, including finding appropriate and knowledgeable provider care teams, ensuring adequate and continuous coverage for services, and ensuring benefit adequacy. Racial disparities and societal risks all exacerbate these challenges. This article outlines recommendations for improving financing for CYSHCN, including potential innovations to address barriers, such as state Medicaid expansion for CYSHCN, greater transparency in medical necessity processes and determinations, and adequate reimbursement and funding. Financing innovations must use both current and new measures to assess value and provide evidence for iterative improvements. These recommendations will require a coordinated approach among federal and state agencies, the public sector, the provider community, and the families of CYSHCN.

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The Louisiana Family Opportunity Act Medicaid Buy-in Program

Abstract: The FOA program thus appears to be filling a niche in coverage needs among families of children with disabilities in Louisiana.

Cited by 5 publications

References 16 publications

Access to care among children with disabilities enrolled in the MassHealth CommonHealth Buy-In program

Access to care among children with disabilities enrolled in the MassHealth CommonHealth Buy-In program

Welfare participation and depression among youth in the United States: A systematic review

Financing Care for CYSHCN in the Next Decade: Reducing Burden, Advancing Equity, and Transforming Systems

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