Medicaid Financing of Early Childhood Home Visiting Programs
Options, Opportunities, and Challenges
Quick SummaryVarious funding streams—federal, state, local, and private—support home visiting programs. Recently, in light of Medicaid's ability to reach so many low-income and at-risk families, interest has been growing in its potential to finance home visiting services for eligible mothers and children.
Inside the Report
The Pew Home Visiting Campaign engaged the National Academy for State Health Policy (NASHP) to conduct a first-of-its-kind investigation into how states are using—or could use—Medicaid to finance home visiting services.
By the Numbers
In 2003, Medicaid financed approximately 1.7 million births, or 41 percent of all U.S. births.
NASHP conducted a literature review and a scan of state policies and practices nationwide to identify mechanisms for supporting home visiting services through Medicaid; prepared six case studies featuring different home visiting models and Medicaid financing methods; and facilitated a meeting at which state and federal government representatives and national home visiting experts discussed the benefits and challenges of Medicaid funding mechanisms.
These case studies include the history and rationale for using Medicaid, describe the services provided by the home visiting programs, and outline the provider requirements and Medicaid billing procedures used. We chose states with experiences representing a range of Medicaid financing mechanisms.
Using Medicaid, the Illinois Department of Human Services is able to claim a 50 percent federal match rate for certain outreach and case management activities delivered through home visiting. Download the case study.
More than 90 percent of the mothers participating in Kentucky’s home visiting program were eligible for Medicaid, a state analysis found. Download the case study.
Through Michigan’s Maternal and Infant Health Program, an initial assessment and up to nine professional visits per pregnancy are billable to Medicaid. Download the case study.
All 12 Medicaid managed care plans in Minnesota have added home visiting as a service. Download the case study.
Vermont’s state plan amendment for Medicaid has supported home visiting programs since 1987. Download the case study.
About 47,000 Medicaid-eligible births occur in Washington State each year, and the First Steps home visiting program serves mothers and infants in nearly half of these cases. Download the case study.