volume 27 number 2

Image of first page of Northwest Bulletin: Family and Child Health

Health Care Reform and Maternal and Child Health in Region X

The fall 2013 issue of the Northwest Bulletin issue provides a brief overview of health care reform in Region X states and implications for maternal and child public health.

  • Heather Vickery and Aaron Katz discuss the important role of Medicaid in improving the health of at-risk pregnant women and children, and the pros and cons of Medicaid expansion for the states.
  • Anna Stiefvater and Beth Gebstadt describe health care reform in Oregon. The state received a health system transformation grant from the Centers for Medicare and Medicaid Services to transform the state's Medicaid system into a network of coordinated care organizations. The authors describe the activities of several coordinated care organizations located throughout the state, highlighting their relationship with their local public health agency and their approach to improving the health of women and children.
  • Jacquie Watson describes the development of two patient-centered medical home demonstration sites in rural eastern Idaho. Because of low patient volume in rural areas, the medical home coordinators for the demonstration sites are based at local public health districts, rather than at primary care practices.
  • In Washington, those receiving Supplemental Security Income—approximately 120,000 children and adults—are now required to enroll in capitated managed care. These managed care plans are required to provide intensive care management to those with special health care needs. Donna Borgford-Parnell and Crystal Tetrick describe a partnership between a public health agency and managed care organization in King County, Washington, where public health nurses provide intensive care coordination services to children with chronic conditions or special needs.
  • The Oregon State Legislature established the Patient-Center Primary Care Home program with the goal that 75% of Oregonians will have access to a primary care home by 2015. School-based health centers are an important part of expanding access to primary care homes. Carol Opheikens and Dawn Creach describe how these centers are being integrated into Oregon's patient-centered primary care home system.
  • In 2011, Healthy Child Care Washington, the primary source of funding for child care health consultants, was terminated. Catherine Dewar Paul and Peggy King illustrate the importance of trained child care health consultants and argue that Washington needs to reinstate its Healthy Child Care Washington program.
  • The Region X state reports illustrate the many activities related to health care reform, from new program activities (Alaska) to the re-design of the state-level health care delivery and payment system (Idaho) to statewide program's reassessment of its role in women's health (Oregon) to the training of in-person assisters (Washington)