Linking Medicaid and child welfare data to support a transition to managed care

In 2013, the Data Center provided analytic support to a project examining Medicaid expenditures for children in foster care in New York State. The purpose of the study was to generate information about patterns of healthcare needs, service delivery, and cost as the state prepared to transition from a fee-for-service health care system to a managed care program. The report Raising the Bar for Health and Mental Health Services for Children in Foster Care: Developing a Model of Managed Care details the analysis, the findings, and the implications for New York’s evolving policy and practice. Download the PDF >

The study revealed that although Medicaid expenditures for children in foster care are exponentially higher than those for the general pediatric population, patterns of health care needs and utilization suggest that the health improvements children experience during their placement in foster care are not regularly sustained and that patterns of inadequate care that children experience before placement often resurface after discharge.

This project is a prime example of the powerful evidence that can be generated when Medicaid data are linked to longitudinal child welfare records. Because the technique enables an analysis of child-specific health needs and child-specific healthcare expenditures over time, it affords policymakers and practitioners the ability to track patterns of child well-being and service utilization before children enter foster care, while they are in care, and after they leave care.

This project was supported by the Council of Family and Child Caring Agencies in cooperation with the New York State Department of Health and the New York State Office of Children and Family Services.