Paying Attention to Children in a Changing Health Care System (1996) / Chapter Skim
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2 Benefits and Systems of Care for Maternal and Child Health Under Health Care Form
2 Benefits and Systems of Care for Maternal and Child Health Under Health Care Form
Pages 33-48
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From page 33... ...
CHAPTER 2 Benefits and Systems of Care for Maternal and Child Health Under Health Care Reform Workshop Highlights Cynthia H Abel, Editor Committee on Maternal and Child Health Under Health Care Reform Board on Health Promotion and Disease Prevention Institute of Medicine and Board on Children and Families Commission on Behavioral and Social Sciences and Education National Research Council / Institute of Medicine National Academy Press Washington, D.C.
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From page 34... ...
34 PAYING ATTENTION TO CHILDREN IN A CHANGING HEALTH CARE SYSTEM CONTENTS SUMMARY 35 INTRODUCTION 36 HEALTH CARE NEEDS OF WOMEN, CHILDREN, AND ADOLESCENTS 38 Health Care Needs of Women, 38 Health Care Needs of Children, 39 Health Care Needs of Adolescents, 40 HEALTH CARE BENEFITS FOR WOMEN AND CHILDREN 40 Defining Medical Necessity, 42 COORDINATED HEALTH CARE SERVICES FOR WOMEN AND CHILDREN 42 Access to Health Care, 43 Public Programs for Maternal and Child Health, 44 CONCLUSION 46 REFERENCES 46
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From page 35... ...
Workshop discussions emphasized, however, that neither health insurance coverage nor better benefits will meet all of the health care needs of women and children. Adequate support is also needed for the public health and community services that many maternal and child health programs promote.
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The discussion of health care benefits for women and children emphasized a need for more attention to family planning services, mental health and substance abuse services, and services for children with special health care needs. Several approaches to benefit design were addressed by workshop participants, including benefit packages from several congressional health care reform proposals, without attempting to reach consensus.
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From page 37... ...
Adequate support is also needed for the public health and community services that many maternal and child health programs promote. For example, women may need transportation or child care services that enable them to use available prenatal care and reproductive health care services.
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From page 38... ...
Participants indicated that these reproductive health services should include, at a minimum: contraceptive services and supplies; diagnosis and treatment of sexually transmitted diseases; prenatal, intrapartum, and postpartum care; regular breast and pelvic exams (including Pap tests) , in accordance with well-recognized periodicity schedules; risk assessment; and adequate education and counselling to support all of these interventions (Klein, 1994)
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From page 39... ...
. Health Care Needs of Children Although most children are fundamentally healthy, they require health care that emphasizes preventive services, such as immunizations, and the monitoring of physical and psychosocial growth and development, with particular attention to sensitive periods in which appropriate care is essential for sound development and progress.
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From page 40... ...
HEALTH CARE BENEFITS FOR WOMEN AND CHILDREN Workshop participants pointed out that there should be continued efforts to design a comprehensive benefits package for women and children in the context of universal health insurance. The discussion of health care benefits for women and children emphasized the need for more attention to family planning services,
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From page 41... ...
Another approach defines a set of covered services or categories in legislation at a general level and identifies an organization or agency, such as a national health benefits board, which will define the amount, scope, and duration of coverage, as well as co-payments for individual services. For example, services covered in some legislative proposals are listed in general categories such as physician and hospital services, prescription drugs, family planning and prenatal care, preventive medicine, mental health and substance abuse services, hospice and home health services, and vision, hearing, and dental care.
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From page 42... ...
. COORDINATED HEALTH CARE SERVICES FOR WOMEN AND CHILDREN Participants in the workshop agreed that many old models for health care delivery are no longer adequate and that health care reform needs to promote a coordinated and collaborative approach, especially for maternal and child health programs.
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From page 43... ...
Managed-Care Organizations Cost containment for health care services provided the initial impetus for reforming health care in the United States. In this context, managed care2 has been suggested as a mechanism to slow the growth of health care costs while 2The term managed care as defined by the IOM (1993b)
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From page 44... ...
Public Programs for Maternal and Child Health Federal and state public health programs that serve women and children include Medicaid; the maternal and child health programs of Title V of the Social Security Act (which provides services to low income women and children, including children with special health care needs) ; the Supplemental Food Program for Women, Infants, and Children; and the federal family planning program of Title X of the Public Health Service Act (Perrin et al., 1994)
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From page 45... ...
Ohio has created a program called Ohio Care, in which they are redesigning their Medicaid program to extend health benefits to underserved populations. Workshop participants agreed that the existing public health system can facilitate the integration and coordination of maternal and child health programs and that collaboration between public health and personal health services providers will be necessary to ensure the availability of comprehensive health care for women and children.
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From page 46... ...
Workshop participants agreed that a priority for the maternal and child health community is to set forth a new vision that values programs for children and women and to define a strategy to carry out this vision to improve and advance their health care. Once the national debate over the financing of health insurance is concluded, federal leadership can help define clinical standards for the entire maternal and child health community.
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From page 47... ...
Committee on Monitoring Access to Personal Health Care Services. Washington, D.C.: National Academy Press.
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From page 48... ...
48 PAYING ATTENTION TO CHILDREN IN A CHANGING HEALTH CARE SYSTEM Teitelbaum, M.A. 1994 The Health Insurance Crisis for America's Children.
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