Costs and Use for Children With Medical Complexity in a Care Management Program

Abstract

made substantial contributions to design, analysis, and interpretation of the data and also participated in drafting and revising the article critically for important intellectual content; Dr Richardson designed the data collection instruments, coordinated data collection, made substantial contributions to design, analysis, and interpretation of the data, and also participated in drafting and revising the article critically for important intellectual content; Mr Rodean made substantial contributions to design, analysis, and interpretation of the data and also participated in revising the article critically for important intellectual content; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work

Children with medical complexity: A concept analysis

“…Hospitals have begun to cohort these patients together, often dedicating entire units to and developing staff expertise in caring for this population 31 . This is due in part to new state and federal monies earmarked specifically for the development of accountable care organizations focusing on care for these patients, who utilize the vast majority of health‐care resources despite their relatively small number 32,33 . These improvements have extended across the health‐care continuum in the form of new chronic care resources, such as postacute care facilities, home health services, and medical homes among others.…”

Healthcare Utilization of Complex Chronically Ill Children Managed by a Telehealth-Based Team

“…Attention to engaging these resources after discharge may have increased a family's capacity to remain at home and feel supported in doing so. This study builds on evidence from other studies that complex care coordination teams can decrease healthcare utilization (15,20,24). In contrast to other programs, our model emphasizes a consultative/co-management strategy and in particular, given our large geographic catchment area, utilizes a telehealth care delivery system almost exclusively for its outpatient follow-up.…”

“…Despite broad variability in their care delivery paradigms, the majority of programs focus on care coordination designed to address not only the medical but also the developmental, emotional, social, and financial needs of children and families ( 19 ). A multicenter cohort analysis recently showed a decrease in spending of 4.6% for complex patients enrolled in care management programs, highlighting not only the clinical importance but also the cost effectiveness of such care coordination teams ( 20 ). Nonetheless, it is not clear what the optimal design (or designs) for such programs should be, or how best to assess the ability of complex care models to produce meaningful improvements in outcomes ( 21 ).…”

Let Telemedicine Enhance Your Medical Home

“…A prevailing theme in this study (and others) [6][7][8] is that experienced primary care providers who have an existing relationship with CMC and their caregivers do make a difference in the health of their most vulnerable patients. Adding telemedicine to their pediatric medical home can enhance that value even more.…”