Research Objective: The recent availability of SCHIP funds to cover previously uninsured children may result in greater numbers of CSHCN in managed care settings. Mechanisms to accurately identify these children are essential to ensure that they receive high quality care and the specialty services they require. This paper examines various strategies for identifying CSHCN and presents descriptive data for the children identified by each strategy. Study Design: 62,100 children, ages 5-19, who were enrolled in a program which became the largest component of the state's CHIP program were included in the analyses. Each of the identification strategies (a diagnostic approach, a high service use approach, and a high health care charges approach) were conducted on this universe of children to determine the children identified by each strategy. Telephone surveys designed to collect additional demographic and child functioning information were conducted on a random sample of identified children. Principal Findings: The diagnostic algorithm identified 17% of the children as having a special need; the other strategies identified between 0.2% - 9% of the population. Significant differences were observed in the demographic characteristics of the children, their health care charges and their resource use. In addition, parent-reported data indicated significant variations in the children’s functioning. Conclusion: The cohort of children identified as having special needs depends on the specific identification strategy. Considerable thought needs to be given to how programs will identify CSHCN and the services that will be provided to them.
Learning Objectives: 1. Describe the characteristics of children identified as having special needs using several identification strategies. 2. Evaluate the advantages and disadvantages of each of the identification strategies. 3. Discuss the implications of each strategy for monitoring access and quality of care for CSHCN
Keywords: Children With Special Needs, Managed Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.