Notes and Disclaimers:
- Projects shown may also be operating in other states (see the Geographic Reach)
AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION
Project Title: "SMARTCare"
Geographic Reach: Florida, Wisconsin
Estimated Funding Amount: $15,871,245
Summary: The American College of Cardiology Foundation project will test the implementation of SMARTCare, which is a combination of clinical decision support, shared decision-making, patient engagement, and provider feedback tools designed to improve care for patients with stable ischemic heart disease. SMARTCare aims to achieve the following goals: 1) a reduction of imaging procedures not meeting appropriate use criteria, 2) a reduction in the percentage of percutaneous coronary interventions not meeting appropriate use criteria while achieving high levels of patient engagement and lower rates of complications, and 3) an increase in the percentage of stable ischemic heart disease patients with optimal risk factor modification. While many of these solutions have been studied and proven effective in isolation, this project will test them in combination. The model will be tested at five sites in Wisconsin and five sites in Florida.
CHILDREN'S HOME SOCIETY OF FLORIDA
Project Title: "Improving child well-being through integrating care in a community school setting"
Geographic Reach: Florida
Estimated Funding Amount: $2,078,295
Summary: The Children's Home Society of Florida project will implement a medical home for students, families, teachers and the community at the Wellness Cottage at Evans High School, which aims to reduce Emergency Department and inpatient utilization, increase sexually transmitted disease awareness, and address food insecurities and traumatic stress. Four community partners including Children's Home Society of Florida (child welfare/behavioral health), the University of Central Florida, Orange County Public Schools and Central Florida Family Health Center will operate the Wellness Cottage, a hub for health, social, behavioral health, parental support, and after-school activities. The Central Florida Family Health Center will provide onsite primary care. Health risk assessments will inform health promotion activities. Student health ambassadors will promote healthy lifestyles. Community health workers will help parents remove barriers to care. The University of Central Florida will provide social work, nursing, and medical interns. Primary Health Maintenance Organizations will facilitate access to the clinic and assist in evaluating health costs. Programs and services targeting wellness will be available in the school and community. It is predicted that the services provided at Evans Wellness Cottage will improve both the physical health and behavioral health of students, staff, and adults living in the targeted area. The model is designed to create a safe environment where students can learn better health care seeking behaviors and personal health management. In addition, informal and formal connections will help facilitate the development of trust and establish critical lines of communication to improve access to care at the Evans Wellness Cottage.
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, Pennsylvania, Texas
Estimated Funding Amount: $23,198,916
Summary: The National Association of Children's Hospitals and Related Institutions 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.