Page 39
Model Application Template for the State Children’s Health Insurance Program
Effective Date:
Approval Date: September 19, 2002 39
Department of Public Aid Sample of Average Weighted Payments per Service For Children 0-18 (Adjusted to FY’99 Dollars)
Liability
Services
Avg Payment
Physicians $ 1,375,679 58,190
$ 23.64
Other Practitioners 50,750 3,046
16.66
Hospital Inpatient 16,592,020 3,256
5,095.83
Hospital Outpatient 125,385 4,850
25.85
Prescribed Drugs 3,293,634 149,441
22.04
Com. Hlth Centers 953,423 26,799
35.58
Home Health Care 1,373,824 4,528
303.41
TOTAL
$23,764,715 250,110
$ 95.02
7.2.1 Access to well-baby care, well-child care, well-adolescent care and childhood and adolescent immunizations. (Section 2102(a)(7)) (42CFR 457.495(a))
In addition to the methods described in Sections 7.2 and 9, the State pays enhanced rates for certain maternal and child health services to providers who meet certain participation requirements.
The Department of Public Aid collaborates with sister agencies on initiatives related to access to care for children. The Department of Human Services provides case management services, including assisting participants in accessing health care services, to pregnant women and families of infant and high risk older children who are eligible for KidCare. Children who receive WIC services are referred for preventive and primary care. The Department works in cooperation with the Department of Public Health to ensure a coordinated effort at increasing the rate of childhood immunizations, lead screening, lowering infant mortality and improving birth outcomes.
As detailed in Section 9, the State measures its performance in several key preventive areas for children, including, but not limited to percent of children with an identified primary health care provider, rate at which primary and preventive health care providers participate in the program, EPSDT participation rate,