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

• Published in: Journal of child health care Vol. 21; no. 3; pp. 263 - 272
• Main Authors: Glassgow, Anne Elizabeth, Martin, Molly A, Caskey, Rachel, Bansa, Melishia, Gerges, Michael, Johnson, Mary, Marko, Monika, Perry-Bell, Kenita, Risser, Heather J, Smith, Peter J, Van Voorhees, Benjamin
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2017
• Subjects: Centers for Medicare and Medicaid Services (U.S.) - economics; Child; Chronic Disease - therapy; Continuity of Patient Care - organization & administration; Delivery of Health Care - organization & administration; Diffusion of Innovation; Hospitalization; Humans; Nursing; Quality of Life; Reimbursement Mechanisms - economics; Telemedicine - utilization; United States; medical complexity; Centers for Medicare and Medicaid Services (United States); child health; delivery of health care; chronic disease
• ISSN: 1367-4935; 1741-2889
• DOI: 10.1177/1367493517712063

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.