Managed Care
NASHP Reviews State Models for Specialized Children's Medicaid Managed Care Programs
The National Academy for State Health Policy published an analysis of how states structure specialized Medicaid managed care programs for children and youth with chronic and complex conditions. The review examines state design choices including eligibility criteria, carved-in versus carved-out services, care coordination requirements, and specialized plan contracting approaches. The analysis is intended to help state Medicaid agencies considering or refining specialized programs for medically complex pediatric populations. No federal policy change or state-specific implementation timeline is reported.
Why it mattersStates face growing pressure to improve care coordination and outcomes for high-cost pediatric populations, and this analysis provides operational models for specialized plan design and contracting strategies that can inform procurement decisions and program redesigns.