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Child health benefits packages: lessons from Minnesota for State Children's Health Insurance Programs
1University of Alabama at Birmingham, School of Public Health 35294-0022, USA. donna.petersen@uab.edu
Maternal and Child Health Journal
|March 23, 2000
Summary
State maternal and child health (MCH) programs can influence child health insurance benefits. Minnesota MCH programs defined "appropriate and necessary" care, impacting the state's Universal Standard Benefits Set.
Area of Science:
- Public Health
- Health Policy
- Child Health Services
Background:
- State Children's Health Insurance Program (SCHIP) enables state maternal and child health (MCH) programs to ensure comprehensive services for children via benefits packages.
- Minnesota's 1994 initiative to develop a universal standard benefits set presented an opportunity for MCH program engagement.
- The MCH program initially lacked direct policy involvement in the benefits set development.
Purpose of the Study:
- To examine how state MCH programs can increase influence in SCHIP policy development.
- To analyze the process by which the Minnesota MCH program defined "appropriate and necessary" care within the context of SCHIP.
Main Methods:
- Policy analysis of the Minnesota SCHIP benefits set development process.
- Case study approach focusing on MCH program's strategic response to legislative inquiry.
- Qualitative assessment of the definition of "appropriate and necessary" care and its adoption.
Main Results:
- The Minnesota MCH program successfully influenced policy by defining "appropriate and necessary" care.
- This definition was adopted by policymakers for the Universal Standard Benefits Set.
- The MCH program's strategic engagement enhanced its policy influence.
Conclusions:
- State MCH programs can actively shape SCHIP benefits packages through targeted policy engagement.
- Defining key terms like "appropriate and necessary" care is a viable strategy for MCH programs to assert influence.
- This Minnesota case study offers a model for other state MCH programs aiming to participate in SCHIP plan development.
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