MCHbest. NPM 15: Continuous and Adequate Insurance
Strategy. Medicaid Buy-In Program
Approach. Adopt a Medicaid Buy-In program for children with disabilities to ensure adequate insurance coverage.
Overview. Adopting a Medicaid Buy-In program may be an effective way for states to create a pathway to Medicaid for children with disabilities whose family income is too high for Medicaid and who have unmet needs and/or whose families incur high out-of-pocket costs for their care.1 The Massachusetts Medicaid Buy-In program, called MassHealth CommonHealth, allows families of children with disabilities to buy into the state’s Medicaid program to cover more services and to defray costs that private insurance does not cover.2
Evidence. Emerging. There is some evidence that community-wide physical activity campaigns increase physical activity among children, increase walking in intervention communities, and may reduce sedentary time among adults, but further research is needed to confirm effects. This strategy has been tested more than once and results trend positive overall. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings). The Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs (CYSHCN) has identified this strategy as an innovative strategy. Read more in their practice report.
Target Audience. Systems.
Outcome. Cover more services and defray costs. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.
Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Adopt a Medicaid Buy-In program for children with disabilities to ensure adequate insurance coverage,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4):
2 Hirschi M, Walter AW, Wilson K, Jankovsky K, Dworetzky B, Comeau M, Bachman SS. Access to care among children with disabilities enrolled in the MassHealth CommonHealth Buy-In program. Journal of Child Health Care. 2019 Mar;23(1):6-19.