Protecting children with chronic illness in a competitive marketplace

Article Abstract:

In the era of managed health care it is important to make sure that children with chronic diseases receive proper care. Such diseases include birth defects, cancer, cerebral palsy, cystic fibrosis and sickle cell disease. Health care expenditures for children with chronic diseases are five times higher than those for healthy children. Because of this, some managed care plans may refuse to enroll families with chronically ill children. Or they may raise their rates, which would cause low-cost families with healthy children to drop out of the plan. This could lead to still higher costs as the plan tries to recover its costs. One way to assure proper treatment for these children is to carve out certain chronic diseases and create a separate payment system for them. Another is to promote children's hospitals, which would avoid duplication of services by each plan.

Care and treatment, Chronically ill children

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Access to Substance Abuse Treatment Services Under the Oregon Health Plan

Article Abstract:

The number of Oregon residents who were treated for substance abuse increased after the 1995 Oregon Health Plan included chemical dependency as a covered benefit in all Medicaid managed care plans. In 1997, about 8% of all covered beneficiaries were treated for substance abuse, up from 5.5% in 1994.

Laws, regulations and rules, Substance abuse

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Receipt of Advice to Quit Smoking in Medicare Managed Care--United States, 1998

Article Abstract:

Many older smokers in Medicare managed care programs have received advice from their doctors to quit smoking. In a survey of 167,201 Medicare patients, about 13% were smokers and 71% said their doctor had urged them to quit smoking.

United States, Aged, Elderly, Surveys, Smokers, Health counseling

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