Variation In State Medicaid Implementation Of The ACA: The Case Of Concurrent Care For Children

More than 55,000 children die each year in the United States, and hospice is used for very few of them at the end of their lives. Nearly one-third of pediatric deaths are a result of chronic, complex conditions, and the majority of these children are enrolled in Medicaid because of disability status...

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Bibliographic Details
Published in:Health affairs (Millwood, Va.) Va.), 2020-10, Vol.39 (10), p.1770-1775
Main Authors: Laird, Jessica, Cozad, Melanie J, Keim-Malpass, Jessica, Mack, Jennifer W, Lindley, Lisa C
Format: Article
Language:English
Subjects:
Beneficiaries
Children
Children & youth
Childrens health
Disability
Enrollments
Finance
Financial planning
Government programs
Health care industry
Health insurance
Hospice care
Implementation
Innovations
Medicaid
Palliative care
Patient Protection & Affordable Care Act 2010-US
Pediatrics
Performance evaluation
Public finance
Regulation
Reimbursement
Terminal illnesses
Workforce planning
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Summary:More than 55,000 children die each year in the United States, and hospice is used for very few of them at the end of their lives. Nearly one-third of pediatric deaths are a result of chronic, complex conditions, and the majority of these children are enrolled in Medicaid because of disability status or the severity of their disease. Changes in Medicaid/ Children's Health Insurance Program regulations under Section 2302 of the Affordable Care Act require all state Medicaid plans to finance curative and hospice services for children. The section enables the option for pediatric patients to continue curative care while enrolled in hospice. We examined state-level implementation of concurrent care for Medicaid beneficiaries and found significant variability in guidelines across the US. The implementation of concurrent care has fostered innovation yet has added barriers to how pediatric concurrent care has been implemented.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2020.01192