In recent years New York State has gradually moved high-need populations out of fee-for-service arrangements and into managed care to improve quality and lower costs. The transition of children in foster care to Medicaid managed care is scheduled to take place in April 2013 for the nearly 6,000 children residing in foster homes supervised directly by local social services departments, and in April 2015 for the nearly 13,000 children residing in foster care settings operated through contracts with licensed foster care agencies.
A report authored by Manatt Health for the Medicaid Institute at United Hospital Fund examines the opportunities and challenges related to transitioning children in foster care into managed care. These are children with intensive physical and behavioral health needs and their care requires a high level of coordination among the many individuals and entities involved in providing for their needs. This report provides an analytical framework to support stakeholders and policymakers in this transition and describes three potential models for implementing managed care for children in foster care: (1) mainstream managed care; (2) mainstream managed care plan with foster care certification; and (3) pediatric special needs plan.