Health care reaches more children under age three in the United States than any other family-facing system and represents the most common entry point for developmental assessment of and services for children. In this article, Adam Schickedanz and Neal Halfon examine how well the child health care system promotes healthy child development early in…

It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

Reviews the changes managed health care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)

Lays the foundation for other articles in this special issue by providing an overview of managed health care as it now operates. Children are increasingly being enrolled in such plans even though there is little information about the effects of managed health care on this population. (SLD)

Reviews measures of dental health in children and the evidence on child dental health. Although children's dental health has improved over the past two decades, many poor children do not receive necessary dental health services, and reasons for this failure are summarized. (SLD)

Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)

Information available so far indicates that children in managed care arrangements are less likely to be seen by pediatric specialists and that families and providers are less satisfied under managed care. In spite of these drawbacks, the managed care approach, modified appropriately, offers new opportunities to provide high-quality medical care…

Presents recommendations for contracting elements that should be adopted by state Medicaid agencies and approaches that should be taken by managed care practices interested in providing high-quality care for children with special needs. These recommendations are based on interviews with administrators from 29 states and 22 plans. (SLD)

Summarizes efforts by state governments to regulate managed care and examines the various actions that states have initiated to credential managed care plans that desire to provide care for Medicaid beneficiaries. In the long run, organizations other than state regulatory agencies may be better equipped to regulate managed care. (SLD)

Preliminary results from the Health Care Reform Tracking Project's baseline survey and site visits to 10 states show that managed care has generally improved access to health care for children, but it has made it more difficult for youths with serious emotional disorders, and uninsured children, to obtain care. (SLD)

Reviews the basic decisions states must make when implementing State Children's Health Insurance Program (CHIP) programs and reports on the decisions states participating in this federal program have made, as reflected in the plans they submitted to the Health Care Financing Administration. Sources of information about the program are included.…

Focuses on the immunization status of children aged 19 to 35 months. Recommended immunizations are described and contrasted with the actual status of immunization. In response to unacceptably low levels of immunization among very young children, the government is aiming at 90% immunization by the year 2000. (SLD)

Recently states have increasingly turned to managed care arrangements to finance and deliver health services to Medicaid beneficiaries. As this trend continues, states should carefully monitor changes in program costs and quality and implications for delivery of pediatric services and health outcomes for children. (SLD)