NATIONAL ASSOCIATION OF CHILDREN’S HOSPITALS AND RELATED INSTITUTIONS
Project Title: "Coordinating All Resources Effectively (CARE) for Children with Medical Complexity"
Geographic Reach: California, Colorado, Florida, Missouri, Ohio, Pennsylvania, Texas
Estimated Funding Amount: $23,198,916
The National Association of Children’s Hospitals and Related Institutions, Inc., part of Children’s Hospital Association, in partnership with children’s hospitals and National Institute for Children’s Health Quality, is receiving an award to test Coordinating All Resources Effectively (CARE) for children with medical complexity (CMC), which aims to inform sustainable change in health care delivery through new payment models supporting improved care and reduced costs for CMC. The population of focus is CMC who have medical fragility and intense medical and coordination of care needs that are not well met by existing health care models. This model aims to improve care and reduce overall health care expenditures for CMC by 1) creating a medically-appropriate tiered system of care so that CMC of varying needs are cared for in the most appropriate settings to meet patient and family needs while lowering costs, 2) designing a payment system that will both sustain these programs and provide sufficient flexibility so that services will meet patient and family needs and 3) creating a learning system so that programs and payers across the country serving this population can rapidly learn from each other to improve care and design and implement effective payment models. At the center of the proposed care model are the principles of accessible, coordinated, continuous, compassionate and family centered care/shared decision making as articulated in the concept of the medical home, which has been associated with fewer hospitalizations, less emergency department use, better health, and lower costs of care.