Fostering Social and Emotional Health through Pediatric Primary Care: A Blueprint for Leveraging Medicaid and CHIP to Finance Change

Center for the Study of Social Policy, Pediatrics Supporting Parents, Manatt
Report
June 2019
This report describes strategies and tools that state Medicaid and Children’s Health Insurance Program (CHIP) agencies, managed care plans, pediatric care providers, and others can use to optimize the social and emotional development of young children through pediatric practice.
woman with stethoscope on toddler

Nearly half of children under age three in the United States get their health insurance through Medicaid and the Children’s Health Insurance Program (CHIP). This blueprint is intended to contribute, in a practical way, to the exploration of how best to support and sustain methods that advance optimal child development. Medicaid and CHIP are designed with the specific needs of children in mind, and the programs’ inherent flexibility can be used to enhance the care that children get through the pediatric medical home. The blueprint not only suggests what could be done to utilize Medicaid and CHIP financing opportunities, but also shows how such financing strategies can be implemented. Authors drew upon federal statutes and regulations, state plans and policy documents, managed care contract language, and other resources to provide specific tools for implementation. They also highlight where strategies are already operating across the country.

The blueprint presents five core strategies and tools that state Medicaid and CHIP agencies, managed care plans, pediatric care providers, and others can use to optimize the social and emotional development of young children through a high-performing approach to pediatric practice. The blueprint provides a detailed description of each core strategy, along with its statutory and regulatory bases; action steps to implement the strategies; tools for implementation, including relevant federal guidance, contract language, sample state plan amendment language, and other helpful material; and examples of policies in effect and activities underway across the country.

Five Core Strategies to Optimize Social and Emotional Development

  1. Cover and support a full range of screening, assessment, and treatment services for children and their parents.
  2. Leverage quality and performance improvement initiatives to spur changes in pediatric practice.
  3. Establish payment models that support and incentivize a focus on the social and emotional development of children.
  4. Facilitate investment in team-based care and training on children’s social and emotional development.
  5. Leverage a CHIP Health Services Initiative to finance interventions aimed at supporting children’s social and emotional development.
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