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Specialized Populations

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Brief

This report explores flu vaccination rates across multiple years for U.S. adults across the 50 states and the District of Columbia as a proxy to identify population subgroups that may be harder to reach with a COVID-19 vaccine.

Commentary

This commentary reviews the key features of the Community Health Access and Rural Transformation Model, an initiative of the Centers for Medicare and Medicaid Services, and outlines considerations for states.

Report

This report uses data from the most recent wave of the Coronavirus Tracking Survey to examine food insecurity among families with school-age children six months into the pandemic.

Report

This report uses data from the most recent wave of the Coronavirus Tracking Survey to assess food insecurity and other key indicators of material hardship and well-being among families with young children.

Commentary

This commentary examines unique strategies states are developing to support the health needs of children and youth with special health care needs who lack access to their usual school-based physical, developmental, and mental health supports. 

Report

This report on the opioid crisis examines wide-ranging unmet community needs and service system limitations, often tied to historical policy failures and/or regional economic challenges.

Report

This report seeks to identify ways in which the opioid crisis is affecting children in families touched by drug use; how parents or caregivers could be better supported; and how service providers and systems could better support families. 

Commentary

This commentary explores what states have learned during the COVID-19 health crisis that could improve their long-term services and supports programs during and beyond the pandemic.

Report

This report explores the strengths and deficiencies of maternal health care financing in the United States and the ways current policies and practices contribute to inequitable maternal health outcomes.

Report

This report examines how the COVID-19 pandemic has forced health systems, including perinatal services and support providers, to rely on telehealth, or the remote provision of care through telecommunications technology, to reach their clients.

Report

This report examines children’s unmet health care needs during the pandemic and identifies strategies to address these gaps, as well as barriers to widespread implementation of these strategies.

Commentary

This commentary explores the potential fiscal impact of the COVID-19 pandemic on Medicaid and early childhood services and offers opportunities to sustain critical services.

Commentary

This commentary explores how adverse childhood experiences contribute to poor health outcomes, and the ways that these are exacerbated by the COVID-19 pandemic.

Report

This report provides perspectives from organizations across the country that serve immigrant families and shares their view on what response efforts have done to support immigrant families during the COVID-19 pandemic. 

Commentary

This commentary analyzes how states are working to protect farmworkers during COVID-19.

Commentary

This commentary outlines some of the collaborative and successful strategies states are taking to protect and support individuals particularly at risk for homelessness.

Commentary

This commentary examines approaches states are taking to protect farmworkers during the COVID-19 pandemic and recommendations for policymakers.

Commentary

This commentary examines the launch of a New Jersey-based Project ECHO initiative to share COVID-19 expertise between specialists and primary care to meet the needs of pregnant and parenting women during the crisis.

Commentary

Destination: Home leadership discuss their county’s initial response to COVID-19 and their organization’s role in providing care and services for homeless individuals during the pandemic. 

Commentary

This commentary outlines challenges facing family caregivers in the COVID-19 environment and new opportunities for states to come to their aid.

Report

This report assesses how the pandemic is affecting family employment and caregiving, financial decisions, and material hardship among parents living with children under age 19.

Webinar & Presentations

This webinar reported on how states are tracking the disproportionate impact of the disease on vulnerable populations and provided a framework for states to examine their COVID-19 response efforts to yield better outcomes for such populations. 

Report

This report focuses on the impact of the COVID-19 pandemic on family employment, financial security, and material hardship among non elderly Hispanic adults by family citizenship status.

Brief

This brief provides an overview of Children Health Insurance Program (CHIP) Health Services Initiatives (HSIs) and identifies ways that states can leverage them as part of their targeted response to the COVID-19 pandemic.

Commentary

This commentary discusses the 1115 waiver applications submitted by states that have the potential to safeguard access to care and increase support for children during the COVID-19 pandemic.

Commentary

This commentary highlights the critical need for PPE and infection control expertise at nursing homes.

Commentary

This commentary discusses the steps states are taking during the COVID-19 pandemic to protect pregnant women and their infants during delivery.

Commentary

This commentary discusses the unique risk for COVID-19 associated with homelessness.

Report

This report assesses the demographic and socioeconomic characteristics of adult food preparation and food service occupations and provides state-level estimates of their numbers and uninsured rates before the outbreak. 

Commentary

This podcast discusses the many ways that states are working to address the challenges surrounding maternal and infant mortality, specifically the significant disparity experienced by black women,

Report

This report describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities in five areas: coverage, enrollment, benefits, models of care, and quality improvement.

Report

This FAQ answers questions about whom the Department of Homeland Security (DHS) public charge rule will impact, what benefits are implicated by the rule, and how the rule might be administered.

Brief

This article examines Advancing Integrated Models (AIM), a project through which eight organizations are designing and piloting new strategies for integrating innovative, “next-generation” approaches to person-centered care for individuals with complex health and social needs.

Report

01.2020 / By ZERO TO THREE

This annual report compares national and state-by-state data on the well-being of infants and toddlers.

Commentary

These four bog posts focus on local and national innovations to offer guidance on serving complex populations.

Report

This FAQ examines who will be affected by the Department of Homeland Security's final public charge rule, what benefits are implicated, and how the rule might be administered.

Report

10.2019 / By Manatt Health

This issue brief examines how state Medicaid agencies, families, advocates, providers and other stakeholders can partner to improve access to services for Medicaid-enrolled children with special health care needs.

Webinar & Presentations

This webinar reviewed the Department of Homeland Security's final version of its public charge rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers.

Report

08.2019 / By Urban Institute

This report shares insights from in-depth interviews with 25 adults in immigrant families who reported that they or a family member avoided participating in safety net programs like Medicaid, SNAP, or housing assistance in 2018 because of immigration concerns.

Report

07.2019 / By Urban Institute

This brief uses the Well-Being and Basic Needs Survey to examine immigrant families’ reported avoidance of activities in various public settings.

Webinar & Presentations

07.2019 / By Vox

This short video explains the effect of Medicaid on children's health.

Brief

06.2019 / By Urban Institute

This brief examines the prevalence of precarious work schedules among working adults whose families participate in federal safety net programs, using data from the December 2018 Well-Being and Basic Needs Survey.

Brief

06.2019 / By Urban Institute

This fact sheet explores the extent to which families of young children experience material hardship and psychological distress.

Brief

06.2019 / By Urban Institute

This fact sheet explores the extent to which families with young children continue to experience food insecurity.

Commentary

In this article, Dan Sumrok, MD, DFASAM, ABAM, ABPM, discusses a possible connection between combat experience and physical and behavioral health problems.

Report

05.2019 / By Urban Institute

This report uses data from the December 2018 Well-Being and Basic Needs Survey to provide systematic evidence on the extent of chilling effects among immigrant families before release of a final public charge rule.

Report

This report explores challenges associated with providing complex care in rural and frontier communities and outlines opportunities to ensure effective programs.

Report

This resource examines changes in health insurance coverage from 2016 to 2017 for children nationwide and in each state.

Report

In this report, ReSource Team members were interviewed on their methods for addressing the needs of extremely medically complex and socially vulnerable individuals.

Report

This study analyzes three programs that use non-traditional workforce strategies to extend the reach of their clinics to better engage complex patients in their homes, at medical appointments, and other locations.

Report

03.2019 / By ZERO TO THREE

This resource compares national and state-by-state data on the well-being of infants and toddlers, and provides national and state-level data to help advance policies to improve the lives of babies and families.

Commentary

Eight states will join Aligning Early Childhood and Medicaid, a multi-state initiative aimed at improving the health and social outcomes of low-income infants, young children, and families through cross-agency collaboration.

Brief

This brief reviews the role that social and economic factors--such as housing, healthy food, and income--play in a “whole person” approach to health care, especially among Medicaid’s low-income enrollees.

Brief

This brief reviews the opportunities state policymakers have to affect the health—and future well-being and productivity—of their youngest residents through their Medicaid programs.

Brief

This brief reviews the growing body of research on Medicaid's health and economic impacts, including access to care; self-reported health status; preventive health screenings; delaying care because of costs; hospital and ED utilization; and mortality rates.

Brief

This brief highlights priority issues for consideration and potential action, including: the structure of the Medicaid agency; enabling coverage and access; addressing the needs of special populations; and value-based payment policies.

Journal Article

01.2019 / By Urban Institute

This study analyzed linked maternal and infant Medicaid claims data and infant birth records in three states to assess treatments and outcomes on maternal and infant health.

Report

This report outlines the activities of three pilot sites pursuing Medicaid-driven strategies to support young children and their families, to help inform other cross-sector partnerships at varying stages of development.

Graphic

This infographic series examines housing affordability, both unaffordable rents overall as well as for specific populations.

Report

The Blueprint for Complex Care provides a strategic plan to support multidisciplinary innovations and accelerate opportunities to improve care for individuals with complex health and social needs.

Report

The Department of Homeland Security’s (DHS) proposed rule, Inadmissibility on Public Charge Grounds, proposes significant changes to how it will determine whether an immigrant is likely to become a “public charge” including, for the first time, the use of Medicaid benefits as a key factor in that analysis.This resource answers popular questions about the rule. 

Brief

This technical assistance tool shares criteria used by innovative organizations that are identifying individuals for their complex care programs, to help others develop or refine eligibility criteria for complex care management programs.

Webinar & Presentations

This webinar featured speakers from AccessHealth Spartanburg in South Carolina and Petaluma Health Center in Northern California who shared strategies for addressing social determinants of health.

Report

This resource highlights articles published since January 2018 that report on the impact of Medicaid expansion in 33 states and DC, organized by health access and outcomes, economic impacts, and coverage impacts.

Brief

10.2018 / By Urban Institute

This brief examines changes in health insurance coverage and health care access and affordability for parents and their children between 2013 and 2018 using data from the Health Reform Monitoring Survey.

Webinar & Presentations

This webinar featured the use of admissions, discharge, and transfer (ADT) data feeds to coordinate care for patients with behavioral health and other complex care issues in Tennessee and Washington. It provided lessons learned, including operational and financing strategies, linkages to quality metrics and outcomes, and alignment with other statewide payment and delivery system efforts.

Report

09.2018 / By Urban Institute

As federal and state policymakers weigh changes to federal programs that help low-income people meet their basic needs for food, medical care and shelter, they run the risk of increasing material hardship, which could have detrimental short- and long-term impacts on children and adults.

Report

This chartbook uses data from the American Community Survey (ACS) to examine health insurance coverage from 2013 to 2016 for children at the national level and in the states.

Graphic

According to 2016 data from the National Survey of Children’s Health, 33.9 percent of children nationwide had trouble affording nutritious meals.

Graphic

According to 2016 data from the National Survey of Children’s Health, 14.4 percent of children nationwide lived in working poor households. Of these, roughly one-third resided in ten states: Mississippi, New Mexico, Arizona, New York, Arkansas, Michigan, Nevada, Alabama, Louisiana, and Texas. 

Journal Article

04.2018 / By Urban Institute

The Affordable Care Act (ACA) made private nongroup health insurance more accessible to nonelderly adults with chronic conditions through the federal and state-based Marketplaces. As repeal of the ACA individual mandate takes effect in 2019, protecting coverage gains while stabilizing nongroup premiums may depend on state-level efforts to spread the risk of enrollees’ health care costs across a balanced insurance pool.

Journal Article

This article analyzes the impact of the Affordable Care Act on health insurance coverage for verterans in states that chose to expand Medicaid and in non-expansion states using data from the 2013 and 2014 American Community Survey. The analysis found a substantial 24 percent relative decline in the rate of uninsurance for U.S. veterans between 2013 and 2014. Coverage gains in rural areas were due to gains in Medicaid and individual market coverage. The increase in the insured rate was three times larger in Medicaid expansion states versus non-expansion states.

Brief

This issue brief summarizes key features of the February 9, 2018 10-year CHIP extension. CHIP covers nearly 9 million children and is a key contributor to record-low levels of uninsurance among children.

Report

This report examines how organizations participating in Transforming Complex Care (TCC), a multi-site national initiative funded by RWJF, are assessing and addressing social determinants of health for populations with complex needs. It reviews key considerations for organizations seeking to use SDOH data to improve patient care.

Brief

Low-income and vulnerable populations often need services and supports outside the scope of a single state agency to live healthy lives. In some states, braiding or blending funding streams lends programs a measure of flexibility, efficiency, and resiliency. Some states are considering whether innovative funding models could help them address the health-related social needs of vulnerable residents.

Webinar & Presentations

This webinar profiles Louisiana’s Permanent Supportive Housing program and  Virginia’s Children’s Services Act, and examines their use of blended or braided funding to help meet the health-related social needs of vulnerable low-income populations.

Report

04.2017 / By Urban Institute

Before the ACA’s implementation, nearly one million veterans—almost one in 10—were uninsured. By 2015, the number of uninsured veterans fell to 552,000. Veterans uninsurance reduced by nearly 40 percent between 2013 and 2015 under the Affordable Care Act.

Report

04.2017 / By Urban Institute

In this report, researchers estimate the impact of the ACA Medicaid expansion on uninsured rates of poor, childless adult citizens, by age, gender, race, income, education, and health.

Brief

CHIP can provide critical financial support to states as they seek to implement cost-effective lead abatement activities to protect children. This issue brief describes the CHIP State Plan option, which does not require a waiver, and the opportunity it provides for states to make significant tangible reductions in lead exposure and improvements to children’s health. The brief includes specific examples in case studies from Michigan and Maryland.

Brief

State agencies across the country, from Medicaid to public health, to social services and corrections, are deeply engaged in multi-sector initiatives to reduce infant mortality. And for good reason: the United States ranks 25th among industrialized countries in infant mortality with a disproportionate number of being African Americans.

Journal Article

This article examines changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act using data from the National Health Interview Survey. The authors found significant improvements in coverage among children, adolescents, and young adults since 2010, along with some gains in access.

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