Related Experiment Video
Updated: Feb 5, 2026
Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
Published on: July 12, 2024
Identifying Children with Special Health Care Needs Using Medicaid Data in New York State Medicaid Managed Care
Lauren S Miller1, Meng Wu1, Anne M Schettine1
1New York State Department of Health, Office of Quality and Patient Safety, Albany, NY.
Insights
A new risk score method accurately identifies children with special health care needs (CSHCN) in Medicaid Managed Care. This tool aids in monitoring care quality for this vulnerable population.
Area of Science:
- Health Services Research
- Pediatric Health
- Health Informatics
Background:
- Identifying children with special health care needs (CSHCN) is essential for assessing healthcare quality disparities.
- Medicaid Managed Care serves a significant population of children, necessitating effective identification methods for CSHCN.
Purpose of the Study:
- To develop and evaluate a novel method for classifying CSHCN within the New York State (NYS) Medicaid Managed Care population.
- To enhance the ability to monitor healthcare quality for children with special health care needs.
Main Methods:
- Utilized secondary data analysis of NYS Medicaid administrative data and the Children with Chronic Conditions (CCC) Screener.
- Developed a risk score using Medicaid administrative data to assess the likelihood of special needs.
- Established a cut point to differentiate between children with and without special needs, validating against the CCC Screener as the gold standard.
Main Results:
- The developed risk score method demonstrated good diagnostic accuracy in identifying CSHCN.
- Sensitivity was 75%, correctly classifying the majority of CSHCN.
- Specificity was 79%, correctly classifying the majority of children without special needs, with an Area Under the Curve (AUC) of 0.77.
Conclusions:
- The new method effectively identifies CSHCN within the NYS Medicaid Managed Care population.
- This tool will support the state in monitoring the quality of care provided to this vulnerable group.
- Accurate identification of CSHCN is foundational for targeted quality improvement initiatives.
Objective:
The ability to identify children with special health care needs (CSHCN) is crucial to evaluate disparities in the quality of health care for children in Medicaid Managed Care. We developed and assessed the accuracy of a new method to classify CSHCN.
Data Sources:
Secondary data analysis was conducted using NYS Medicaid administrative data and the Children with Chronic Conditions Screener (CCC Screener).
Study Design:
This study included 5,907 NYS Medicaid beneficiaries (17 years old or younger) whose parents completed the CCC Screener in 2014. Medicaid administrative data were used to create a risk score to assess the risk of special needs, and a cut point was identified to differentiate between children with versus without special needs. Diagnostic accuracy of the method was assessed using sensitivity and specificity analyses.
Principal Findings:
Applying the CCC Screener as the "gold standard," the risk score correctly classified the majority of CSHCN as positive (sensitivity = 75 percent) and the majority of the children without special needs as negative (specificity = 79 percent). This method demonstrated decent diagnostic ability (AUC = 0.77).
Conclusions:
Our method can identify CSHCN in the NYS Medicaid Managed Care population and will help the State monitor the quality of care for this vulnerable population.
Related Concept Videos
01:21Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
01:18Interdisciplinary Care: The Health Care Team-II
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:26Traditional Level Of Health Care System
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...