Resources — 115th Congress
Talking Points — 115th Congress
- On Dec. 11, the House passed H.R. 7217, The Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE Act), which includes the Advancing Care for Exceptional Kids Act (ACE Kids Act). The ACE Kids is designed to improve care for children with medical complexity in Medicaid. The ACE Kids Act enjoys strong bipartisan support in the Senate and House, and the support of over 30 national health care groups. However, the IMPROVE Act was not passed in the Senate before the 115th Congress adjourned.
- Medicaid covers over 37 million children, and a small percentage of these kids have complex medical conditions requiring ongoing and specialized care; their care accounts for a drastically disproportionate percentage of Medicaid spending on children. The ACE Kids Act addresses existing challenges — identified by families and physicians — facing these children, including the provision and coordination of care across multiple providers and services, and easing access to out-of-state care.
- The ACE Kids Act would expand access to patient-centered, pediatric-focused coordinated care models tailored for children with medical complexity.
- This concept works. Results have been demonstrated through the Center for Medicare and Medicaid Innovation (CMMI). The ACE Kids method reduced costs and improved quality based on the documented care of thousands of children. CMMI's Coordinating All Resources Effectively (CARE) award — involving 10 children's hospitals with eight different state Medicaid programs, including D.C. — reduced emergency department visits by 26 percent and reduced inpatient days by 32 percent. In the first full year of operations coordinating care for 8,000 children, CARE ultimately reduced overall costs by 2.6 percent while improving patient experience. The ACE Kids Act would enable these innovations to spread nationally.
- ACE Kids would be optional for states, providers and families. Further, it would work within the existing structure of a state's Medicaid program, including those states with Medicaid managed care. The bill would allow for the creation of enhanced pediatric health homes and provide incentives for states to participate.
- The bill creates a national framework to improve data collection and quality of care. It will also allow for better coordination for out-of-state care, and spur innovation and the sharing of best practices between states.
The ACE Kids Act would improve Medicaid for the sickest children and reduce program spending.
We ask lawmakers to pass the ACE Kids Act this year.