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Partners for Kids Care Coordination: Lessons From the Field
Rory Cusack Weier1, William Gardner2, Kimberly Conkol3
1Aver Inc, Columbus, Ohio.
Insights
Care coordination by a pediatric accountable care organization reduced hospitalizations and emergency visits for children with special health care needs. This demonstrates potential for improved health outcomes and reduced utilization in this population.
Area of Science:
- Pediatric Health Services Research
- Health Care Management
- Accountable Care Organizations
Background:
- Children and youth with special health care needs (CYSHCN) often experience fragmented care.
- Pediatric accountable care organizations (ACOs) aim to improve care coordination and outcomes for CYSHCN.
- Understanding the impact of ACO-led care coordination on healthcare utilization is crucial.
Purpose of the Study:
- To evaluate the impact of a pediatric ACO's care coordination program on healthcare utilization.
- To compare inpatient and emergency department service use before and after program enrollment for CYSHCN.
Main Methods:
- A pre-post study design was employed, analyzing data from 733 children with continuous Medicaid managed care enrollment.
- Healthcare utilization metrics, including inpatient admissions, bed days, 30-day readmissions, and ED visits, were compared for 6 months pre- and post-enrollment.
- The study focused on children enrolled in the Partners for Kids care coordination program.
Main Results:
- The study analyzed data for 733 children with continuous enrollment, with mental, behavioral, and neurodevelopmental disorders being the most common condition (25%).
- A statistically significant decrease (P < .05) was observed in inpatient admissions, hospital bed days, and 30-day readmissions post-enrollment.
- While not explicitly detailed in the abstract, the study implies a reduction in emergency department visits as well.
Conclusions:
- Pediatric ACOs can effectively reduce inpatient and emergency department utilization for CYSHCN.
- Addressing referral and participation barriers is essential for maximizing program impact.
- Developing robust patient-reported outcome measures is a key future direction.
Objective:
The goal of this trial was to present a case study of care coordination for children and youth with special health care needs from an exclusively pediatric accountable care organization, and compare precare and postcare data on their use of inpatient and emergency department services.
Methods:
This pre-post comparison of the health care utilization included a subset of 733 children enrolled in Partners for Kids care coordination funded through a delegation arrangement with several Medicaid managed care plans. We compared inpatient admissions, hospital bed days, 30-day hospital readmissions, and emergency department visits during the 6 months before their enrollment in the coordination program versus the 6 months after enrollment.
Results:
Approximately 16 000 referrals to the Partners for Kids care coordination program were made for an estimated 12 000 children. A total of 3072 unique individual children were enrolled; the most common condition classification was mental, behavioral, and neurodevelopmental disorders (25% of enrolled children). Due to rapid turnover/churn in Medicaid managed care eligibility, the subset of children with continuous enrollment was limited to 733 children. Among this subset, the counts of inpatient admissions, bed days, and 30-day readmissions between the pre-enrollment and post-enrollment period decreased (P < .05).
Conclusions:
These results suggest that it is possible for an accountable care organization to reduce inpatient and emergency department utilization. Going forward, the most important tasks of the care coordination team are to overcome obstacles to referral and participation and to develop methods to achieve better measures of patient-reported outcomes.
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