Publications by Wilma Tilson for Health Policy Center

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To gain a more complete understanding of the effects of managed care on service delivery for children with special health care needs (CSHCN), a qualitative evaluation of eight states with different Medicaid managed care models was conducted. Key findings included: mainstream managed care systems, while providing an important locus of organization and accountability for the delivery of primary and specialty medical care, often fell short of being able to identify and serve CSHCN among their enrolled children, to integrate with non-medical systems of care, and to provide intensive case management to support CSHCN; specialty managed care systems, designed specifically to service CSHCN, succeeded more fully in addressing the diverse needs of this population through their unique service delivery and care coordination strategies; and traditional fee-for-service systems offered the least structure and no formal mechanisms for coordinating resources across health, mental health, educational, and other systems of care. (Journal of Health Care Law and Policy 2001; 5(1): 208-232).

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