Children in the child welfare system typically have extensive health care needs, including significant behavioral and chronic physical health issues. Vulnerable to frequent disruptions in living situations, these children often experience fluctuating access to health care, little continuity of care, and poorly coordinated care, all of which lead to high health care costs. Medicaid provides health insurance coverage for the majority of children in child welfare, and many states enroll this population in managed care programs. As a result, Medicaid health plans are uniquely positioned to address quality improvement for these children.

Improving Outcomes for Children in Child Welfare: A Medicaid Managed Care Toolkit, developed by the Center for Health Care Strategies, can help guide efforts to improve care for this at-risk population. The toolkit details the work of nine managed care organizations (MCOs) that participated in a three-year CHCS quality improvement collaborative supported by the Annie E. Casey Foundation. The participating plans undertook innovative pilot projects to improve care for children in child welfare, focusing on: (1) access to physical and behavioral health care services; (2) coordination of care; and (3) appropriate use and monitoring of psychotropic medications.

The toolkit details the pilot efforts of each plan, including identification, stratification and outreach strategies developed, as well as obstacles faced and preliminary outcomes achieved. This resource is designed to help states, health plans, child welfare agencies, providers, and other child-serving stakeholders develop the approach to care and cross-system collaboration required to improve outcomes for this high-need population of children.