State Innovations in Child Welfare Financing. Chapter 2: Overview of the Initiatives


This review focuses on 23 initiatives in 22 states. Each of the initiatives involves the implementation of financial arrangements to influence the behavior of private agencies. The fiscal strategies used by the states include capitated and case rates, risk sharing, performance contracting, performance incentives, privatization, and pooled or flexible funding. Although strictly speaking not all are managed care initiatives, most have incorporated managed care strategies (such as prospective payments, utilization management, and service coordination) at least to some extent.

This section provides an overview of the initiatives that were reviewed. Table 2-1 provides a descriptive summary of the initiatives. The information is “point-in-time” as of fall 2001, and much may have changed since it was collected, especially since most of the initiatives had been implemented relatively recently (see the table) and were still evolving. The information does illustrate the range of approaches states are using to better serve children and families. The report does not attempt to describe or draw any conclusions about the effectiveness of the initiatives; a few of the initiatives are being evaluated and will have that information (or do already) but evidence is still preliminary or lacking for most.

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