An innovative health-care delivery model for children with medical complexity

Abstract

Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC. The CHECK program uses a combination of high-tech and low-tech interventions to connect patients, stakeholders, and providers. It is anticipated that the investment in additional support services to CMC will result in improved quality of care that leads to a reduction in unnecessary inpatient hospitalizations, readmissions, and emergency department visits and a total cost savings. The CHECK program has the potential to inform future cost-effective health-care models aimed at improving the quality of life and care for CMC and their families.

Schools and Health: An Essential Partnership for the Effective Care of Children with Chronic Conditions

“…The main component of the CHECK model relies on Community Health Workers (CHWs) to work with enrolled families to develop individualized plans that seek to address the myriad reasons families have challenges managing their child's chronic condition. The complete CHECK theoretical model and full range of interventions are discussed elsewhere . CHECK has implemented a comprehensive, community‐focused intervention to serve children ages birth to 25 years who are enrolled in Medicaid, live in Cook County, Illinois, and have asthma, diabetes, sickle cell disease, or prematurity.…”

“…The complete CHECK theoretical model and full range of interventions are discussed elsewhere. 12 CHECK has implemented a comprehensive, community-focused intervention to serve children ages birth to 25 years who are enrolled in Medicaid, live in Cook County, Illinois, and have asthma, diabetes, sickle cell disease, or prematurity. The school focus of the CHECK model follows the tenets of the WSCC model (Table 1), which calls for greater collaboration across the community, school, and other sectors to meet the needs of each child.…”

Exploring Racial Disparities in Mental Health Diagnoses and Neighborhood Disorganization Among an Urban Cohort of Children and Adolescents with Chronic Medical Conditions

“…A full description of the CHECK intervention model is described elsewhere. [20][21][22][23] Data for this study were collected from December 1, 2014 through September 1, 2017. CHECK participants were identified for eligibility based on Medicaid claims data from the Illinois Medicaid agency, Medicaid managed care organizations, direct referrals from providers, or self-referrals.…”

A multivariable analysis of childhood psychosocial behaviour and household functionality

“…Further care coordination is planned by risk and implemented along with appropriate, customized follow‐up. Overall, the interventions focus on improving affect regulation in the child and parent as fundamental “building blocks” of resiliency and family function (Glassgow et al, ).…”

“…The programme is unique as it has integrated mental health services into a large‐scale care model of comprehensive health care delivery for children with chronic medical conditions (Glassgow et al, ). CHECK targets children and young adults (aged 0–25 years), who are enrolled in Medicaid with a chronic disease, such as asthma, diabetes, sickle cell disease, or prematurity (Glassgow et al, ). Establishing a system of family‐centred care, the CHECK programme offers a model to merge social and health services to obtain improved care for children with medical complexity.…”