Research Article
Children's HealthVariation In State Medicaid Implementation Of The ACA: The Case Of Concurrent Care For Children
- Jessica Laird is a nursing student in the College of Nursing at the University of Tennessee, Knoxville, in Knoxville, Tennessee.
- Melanie J. Cozad is an assistant professor in the Department of Health Services Policy and the Management Center for Effectiveness Research in Orthopedics at the University of South Carolina, in Columbia, South Carolina.
- Jessica Keim-Malpass is an associate professor in the School of Nursing, University of Virginia, in Charlottesville, Virginia.
- Jennifer W. Mack is an associate professor in Pediatric Oncology and the Division of Population Sciences at the Dana-Farber Cancer Institute and Boston Children’s Hospital, in Boston, Massachusetts.
- Lisa C. Lindley ([email protected]) is an associate professor and Nightingale Endowed Faculty Fellow in the College of Nursing at the University of Tennessee, Knoxville.
Abstract
More than 55,000 children die each year in the United States, and hospice is used for very few of them at the end of their lives. Nearly one-third of pediatric deaths are a result of chronic, complex conditions, and the majority of these children are enrolled in Medicaid because of disability status or the severity of their disease. Changes in Medicaid/Children’s Health Insurance Program regulations under Section 2302 of the Affordable Care Act require all state Medicaid plans to finance curative and hospice services for children. The section enables the option for pediatric patients to continue curative care while enrolled in hospice. We examined state-level implementation of concurrent care for Medicaid beneficiaries and found significant variability in guidelines across the US. The implementation of concurrent care has fostered innovation yet has added barriers to how pediatric concurrent care has been implemented.
