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Children’s Special Health Care Services (CSHCS)
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Children’s Special Health Care Services (CSHCS) Strategic Planning April 16 -17, 2008 Kathy Stiffler, Director
description
Children’s Special Health Care Services (CSHCS). Strategic Planning April 16 -17, 2008 Kathy Stiffler, Director. CSHCS Expenditures By Provider Type FY06. CSHCS Expenditures By Provider Type FY07. Top Ten Expenditures By Diagnosis Group – FY06. - PowerPoint PPT Presentation
Transcript of Children’s Special Health Care Services (CSHCS)
Children’s Special Health Care Services (CSHCS)
Strategic PlanningApril 16 -17, 2008
Kathy Stiffler, Director
CSHCS - FY07 - CSHCS, Title V/XIX & Title V enrollmentAverage Monthly Enrollment: CSHCS = 31,567, Title V/XIX=19,409 Title V= 12,159
5,000
10,000
15,000
20,000
25,000
30,000
35,000
Month - Year
Nu
mb
er E
nro
lled
Total
Title V/XIX
Title V
Total 31,524 31,580 31,569 31,619 31,579 31,591 31,474 31,418 31,362 31,548 31,668 31,876
Title V/XIX 19,369 19,385 19,399 19,415 19,410 19,422 19,374 19,343 19,286 19,445 19,437 19,619
Title V 12,155 12,195 12,170 12,204 12,169 12,169 12,100 12,075 12,076 12,103 12,231 12,257
OCT 2006
NOV 2006
DEC 2006
JAN 2007
FEB 2007
MAR 2007
APR 2007
MAY 2007
JUN 2007
JUL 2007
AUG 2007
SEP 2007
16,545
20,230
0 5000 10000 15000 20000 25000
Number Enrolled
Female
Male
Gender
CSHCS: March 2007 - February 2008 - Enrollment By GenderTotal Population: 36,775
Number Enrolled 16,545 20,230
% of Total Population 45% 55%
Female Male
Male
Female
Less Than Age 1
Age 1
957
711
614
455
0
100
200
300
400
500
600
700
800
900
1000
Number Enrolled
CSHCS: February 2008 - Enrollment By Age and Gender - Focus Group: Age 0-1Total Population: 32,396
Less Than Age 1 614 455
Age 1 957 711
Male Female
CSHCS: February 2008 - Enrollment By AgeTotal Population: 32,396
8,177
8,004
7,867
3,059
3,637
583
1,069
0 1000 2000 3000 4000 5000 6000 7000 8000 9000
21+
18-20
16-17
11-15
6-10
1-5
<1
Number Enrolled
% of Total Population 2%11%9%24%25%25%3%
Number Enrolled 5833,6373,0597,8678,0048,1771,069
21+18-2016-1711-156-101-5<1
CSHCS: February 2008 - Client with Other Insurance (Title 5 vs Title 5/19)Total Population: 32,396
Title 5 without Other Insurance
12%
Title 5 with Other Insurance
26%
Title 5/19 with Other Insurance
11%Title 5/19 without Other Insurance
51%
16,450
8,517
3,621
3,808
CSHCS Expenditures By Fiscal Year and Funding Source
$0.0
$20.0
$40.0
$60.0
$80.0
$100.0
$120.0
$140.0
$160.0
$180.0
$200.0E
xpen
dit
ure
s (I
n M
illio
ns)
Total
Title V/XIX
Title V
Total $86.8 $91.0 $97.4 $94.1 $82.0 $94.2 $123.6 $139.3 $148.5 $174.6 $179.7 $175.6 $187.5
Title V/XIX $64.1 $67.6 $72.1 $68.8 $58.5 $67.4 $89.6 $105.6 $115.2 $137.9 $139.7 $135.6 $147.9
Title V $22.7 $23.4 $25.2 $25.3 $23.6 $26.9 $34.0 $33.7 $33.3 $36.7 $39.9 $39.9 $39.6
FY-95 FY-96 FY-97 FY-98 FY-99 FY-00 FY-01 FY-02 FY-03 FY-04 FY-05 FY-06 FY-07
CSHCS Annual Expenditures and Average Enrollment
$-
$15,000,000
$30,000,000
$45,000,000
$60,000,000
$75,000,000
$90,000,000
$105,000,000
$120,000,000
$135,000,000
$150,000,000
$165,000,000
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
Title V/XIX $ $67,351,453 $89,588,468 $105,648,955 $115,205,566 $137,901,346 $139,746,950 $135,622,768 $147,922,224
Title V $ $26,890,211 $34,048,507 $33,658,159 $33,288,751 $36,724,615 $39,955,465 $39,976,636 $39,615,762
Title V/XIX Average 11,860 14,010 15,688 14,977 16,660 17,699 18,342 18,878
Title V Average 13,329 14,499 14,320 12,128 12,445 12,533 12,107 12,020
FY-00 FY-01 FY-02 FY-03 FY-04 FY-05 FY-06 FY-07
CSHCS Average Enrollment Per Fiscal YearTitle V vs. Title V/XIX
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
Title V/XIX 9,596 9,414 9,222 11,860 14,010 15,688 14,977 16,660 17,699 18,342 18,878
Title V 11,210 11,140 11,157 13,329 14,499 14,320 12,128 12,445 12,533 12,107 12,020
FY-97 FY-98 FY-99 FY-00 FY-01 FY-02 FY-03 FY-04 FY-05 FY-06 FY-07
CSHCS Medical Care & Treatment ExpendituresFiscal Years '00 - '07
$123,636,975
$139,307,114
$94,241,664
$149,979,881
$174,625,961 $175,599,404
$187,537,986
$179,702,415
$-
$15,000,000
$30,000,000
$45,000,000
$60,000,000
$75,000,000
$90,000,000
$105,000,000
$120,000,000
$135,000,000
$150,000,000
$165,000,000
$180,000,000
$195,000,000
$210,000,000
FY-00 FY-01 FY-02 FY-03 FY-04 FY-05 FY-06 FY-07
CSHCS Expenditures By Provider TypeFY06
Pharmacy50%
Home Health10%
Outpatient Hospital7%
DME8%
Inpatient Hospital22%
Physician3%
Ancillary Services0%
Vision0%
Hearing/Speech0%
Dental0%
Pharmacy
DME
Inpatient Hospital
OutpatientHospitalHome Health
Physician
Hearing/Speech
Dental
Vision
Ancillary Services
CSHCS Expenditures By Provider Type
FY06
Service Expenditure
Pharmacy $ 85,587,625
DME $ 14,887,175
Inpatient Hospital $ 37,614,619
Outpatient Hospital $ 13,093,771
Home Health $ 17,002,767
Physician $ 5,604,711
Hearing/Speech $ 716,280
Dental $ 846,225
Vision $ 40,463
Ancillary Services $ 205,768
Total $ 175,599,404
CSHCS Expenditures By Provider TypeFY07
Physician3%
Dental0%
Hearing/Speech0% Vision
0%
Ancillary Services0%
Home Health10%
Outpatient Hospital7%
Inpatient Hospital23%
DME7%
Pharmacy50%
Pharmacy
DME
Inpatient Hospital
Outpatient Hospital
Home Health
Physician
Hearing/Speech
Dental
Vision
Ancillary Services
Service Expenditure
Pharmacy $ 91,225,682
DME $ 14,036,028
Inpatient Hospital $ 43,840,869
Outpatient Hospital $ 13,215,151
Home Health $ 18,181,154
Physician $ 5,266,497
Hearing/Speech $ 581,306
Dental $ 928,857
Vision $ 51,879
Ancillary Services $ 210,563
Total $ 187,537,986
CSHCS Expenditures By Provider TypeFY07
Top Ten Diagnosis Groups By FrequencyFY06
27%
23%
9%
7%
4% 3%
13%
6%
4%
4%
Congenital Anomalies
Diseases of the Central Nervous System(Including Cerebral Palsy)
Diseases of the Endocrine Glands(Including Diabetes)
Diseases of the Ear
Diseases of the Respiratory System
Diseases of the Blood and Blood FormingOrgans (Including Hemophilia)
Metabolic Diseases
Certain Diseases of the Newborn(Including Respiratory Distress Syndrome)
Cancer (Excluding Neoplasms of Bloodand Lymph Systems
Diseases of the Kidney and UrinarySystem (Including Nephritus andNephrosis)
Congenital Anomalies
Central Nervous
SystemEndocrine
Ear
Respiratory
Blood
Metabolic
Newborn
Kidney/Urinary
Cancer
Top Ten Expenditures By Diagnosis Group – FY06
Diagnosis Groups Sub-Group
Group Diagnosis Codes Expenditures
Number of Cases
Diseases of the Blood and Blood Forming Organs (Including Hemophilia) 280 - 289 $ 38,974,159.98 1,651
Diseases of the Central Nervous System (Including Cerebral Palsy) 320 - 349 $ 35,724,536.52 6,475
Congenital Anomalies 740 - 759 $ 28,113,688.46 7,518
Congenital Heart Disease 745 - 747 $ 7,724,041.46 1,748
Cleft Lip and Cleft Palate 749 - 749 $ 2,226,517.17 1,343
Certain Deformities and Anomalies of Limbs 754 - 755 $ 1,624,424.65 650
Diseases of the Endocrine Glands (Including Diabetes) 240 - 259 $ 13,111,029.16 3,619
Metabolic Diseases 270 - 279 $ 12,108,418.97 1,243
Certain Diseases of the Newborn (Including Respiratory Distress Syndrome) 760 - 778 $ 9,790,895.82 1,212
Cancer (Excluding Neoplasms of Blood and Lymph Systems 140 - 199 $ 6,600,738.94 1,108
Cancer of the Lymphatic and Hemtopoitic Systems (Including Leukemia) 200 - 209 $ 4,601,036.75 687
Diseases of the Respiratory System 460 - 519 $ 4,371,441.43 1,871
Diseases of the Kidney and Urinary System (Including Nephritus and Nephrosis) 580 - 599 $ 3,252,680.26 708
Top Ten Diagnosis Groups By FrequencyFY07
23%
14%
8%
7%
6%
4%4% 3%
27%4%
Congenital Anomalies
Diseases of the Central Nervous System(Including Cerebral Palsy)
Diseases of the Endocrine Glands(Including Diabetes)
Diseases of the Ear
Diseases of the Respiratory System
Diseases of the Blood and Blood FormingOrgans (Including Hemophilia)
Metabolic Diseases
Cancer (Excluding Neoplasms of Bloodand Lymph Systems
Certain Diseases of the Newborn(Including Respiratory DistressSyndrome)Cancer of the Lymphatic and HemtopoiticSystems (Including Leukemia)
Congenital Anomalies
Central Nervous System
Endocrine
Ear
Respiratory
Blood
Metabolic
Cancer
Newborn
Lymphatic
Diagnosis Groups Sub-Group
Group Diagnosis Codes Expenditures
Number of Cases
Diseases of the Blood and Blood Forming Organs (Including Hemophilia) 280 - 289 $ 46,159,515.97 1,681
Diseases of the Central Nervous System (Including Cerebral Palsy) 320 - 349 $ 34,163,576.85 6,414
Congenital Anomalies 740 - 759 $ 31,780,408.95 7,598
Congenital Heart Disease 745 - 747 $ 9,324,681.22 1,835
Cleft Lip and Cleft Palate 749 - 749 $ 2,310,062.51 1,320
Certain Deformities and Anomalies of Limbs 754 - 755 $ 1,933,341.36 652
Diseases of the Endocrine Glands (Including Diabetes) 240 - 259 $ 13,759,988.70 3,872
Metabolic Diseases 270 - 279 $ 12,028,529.29 1,258
Certain Diseases of the Newborn (Including Respiratory Distress Syndrome) 760 - 778 $ 9,991,988.13 1,142
Cancer (Excluding Neoplasms of Blood and Lymph Systems 140 - 199 $ 7,127,039.05 1,168
Cancer of the Lymphatic and Hemtopoitic Systems (Including Leukemia) 200 - 209 $ 6,235,019.04 711
Diseases of the Respiratory System 460 - 519 $ 5,355,826.89 1,944
Diseases of the Kidney and Urinary System (Including Nephritus and Nephrosis) 580 - 599 $ 3,704,899.33 743
Top Ten Expenditures By Diagnosis Group – FY07
CSHCS FY08 Appropriation = $199,420,300
General Fund (Michigan), $97,679,400Title XIX (Federal),
$90,555,100
Fees & Collections, $2,295,000
MCH Block Grant, $8,890,800 General Fund (Michigan)
Title XIX (Federal)
MCH Block Grant
Fees & Collections
Status of Fiscal Year ‘08October 2007 – March 2008
Title V Expenditures: $21,599,046
Title V/XIX Expenditures: $75,613,106
Total Expenditures: $97,212,152
CSHCS and Birth Defects CSHCS data linked to Birth Defects
Registry (BDR) data Identify missing BDR cases Identify BDR children with eligible CSHCS
diagnosis
Race /Ethnicity MBDR Cases with CSHCS diagnosis
CSHCS Covered %
White 29,820 24
Black 10,109 24.9
Amer. Indian 205 28.8
Asian/PI 1,248 13.3
Hispanic 1,928 25.1
Arab 1,387 16.7
Total 45,224 23.7
MCHB Core Outcomes MI % Nation %
CSHCN whose families are partners in decision-making at all levels, and who are satisfied with the services they receive
56.4 57.4
CSHCS who receive coordinated, ongoing, comprehensive care within a medical home
45.9 47.1
CSHCS whose families have adequate private and/or public insurance to pay for the services they need
60.8 62.0
CSHCN who are screened early and continuously for special health care needs
68.8 63.8
CSHCN whose services are organized in ways that families can use them easily
90.9 89.1
Youth with SHCN who receive the services necessary to make appropriate transitions to adult health care, work, and independence
40.8 41.2
HispanicWhite
BlackMulti-Racial
Other
Michigan
Nationw ide
46.4
61
53.556.7
47.2
43.1
59.6
44.9
66.4
49.6
0
10
20
30
40
50
60
70
% Successfully Achieved
Race/Ethnicity
CSHCN whose families partner in decision-making at all levels and are satisfied with the services they receive
By: Race/Ethnicity
Michigan
Nationw ide
0%-99%100%-199%
200%-399%
400% orgreater
Michigan
Nationw ide
50.252.6
58.8
64.7
49.1
49.8
58.2
65
0
10
20
30
40
50
60
70
% Sucessfully Achieved
% Federal Povery Level
CSHCN whose families are partners in decision-making at all levels and are satisfied with the services they receive By: Household Income
Michigan
Nationw ide
Functional
LimitationsManaged by Rx
MedsAbove Routine
need/ use
ser vices
Rx Meds and
Ser vices
Michigan
Nationwide
53.7
67.9
55.1
62.7
56.2
69.5
43.1
61
0
10
20
30
40
50
60
70
% Successfully Achieved
Types of Health Needs
CSHCN whose families have adequate private and/or public insurance to pay for the services they need
By: Types of Health Needs
Michigan
Nationw ide
CSHCNw ithout
Medical Home
CSHCN w ithMedical Home
Michigan
Nationw ide
6168.1
67.5
73.3
010
20
30
40
50
60
70
80
% Successfully Achieved
Presence of Medical Home
CSHCN who are screened early and continuously for special health care needs By: Presence of Medical Home
Michigan
Nationw ide
PrivateInsurance Public
Insurance Both Privateand Public Uninsured
Michigan
Nationw ide
70.3
54.7 61.1
34.5
74.6
55.7
77.6
33
0
10
20
30
40
50
60
70
80
% Successfully Achieved
Type of Insurance
CSHCN who are screened early and continuously for special health care needs By: Type of Insurance
Michigan
Nationw ide
FunctionalLimitations
Managed byRx Meds
AboveRoutine
need/useservices
Rx Medsand
services
Michigan
Nationw ide
77.6
96.7
83.788.7
82.9
97
88.7
89.4
0
10
20
30
40
50
60
70
80
90
100
% Successfully Achieved
Type of Health Needs
CSHCN whose services are organized in ways that families can use them easily By: Type of Health Needs
Michigan
Nationw ide
PrivateInsurance
Only
PublicInsurance
Only
Both Privateand Public Uninsured
Michigan
Nationw ide
91.786.4
85.2
73.9
92.3 89.691.1
67.4
0
10
20
30
40
50
60
70
80
90
100
% Successfully Achieved
Type of Insurance
CSHCN whose services are organized in ways that families can use them easily By: Type of Insurance
Michigan
Nationw ide
Private InsurancePublic Insurance
Both Private andPublic
Michigan
Nationw ide
49.1
27.532.1
47.8
25.8
25.3
0
10
20
30
40
50
% Successfully Achieved
Type of Insurance
Youth with special health care needs who receive the services necessary to make the appropriate transitions to adult health care, work, and independence (ages 12-17 only)
By: Type of Insurance
Michigan
Nationw ide
FunctionalLimitations
Managed byRx Meds
AboveRoutineneed/useservices
Rx Medsand service
use
Michigan
Nationw ide
29.9
49.9
31.6
42
33.2
48.4
36.3 39
0
10
20
30
40
50
% Successfully Achieved
Type of Special Health Needs
Youth with special health care needs who receive the services necessary to make appropriate transitions to adult health care, work, and independence (ages 12-17 only)
By: Types of special health needs
Michigan
Nationw ide
2007 CSHCS Age-Out Statistics
Total Client who turn 21 = 961
Total Clients Continuing Coverage= 41 4% of total age-out population
Total Clients aging out of CSHCS = 920
2007 Age-Out Statistics
Top Age-Out Diagnosis
Description Percent of Population
Diabetes (all type I) 15%
Cerebral Palsy 6%
Epilepsy 5%
Hearing Loss 4%
Quadriplegia 4%
Sickle Cell 3%
CSHCS Strategic Planning
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