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An innovative health-care delivery model for children with medical complexity
Anne Elizabeth Glassgow1, Molly A Martin1, Rachel Caskey1
11 Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL, USA.
Insights
The Coordinated Health Care for Complex Kids (CHECK) program improves care for children with medical complexity. This innovative model aims to reduce hospitalizations and costs through better coordination.
Area of Science:
- Pediatric Healthcare Innovation
- Health Services Research
- Healthcare Management
Background:
- Children with medical complexity (CMC) drive significant pediatric healthcare utilization and costs.
- High costs are linked to prolonged hospitalizations, frequent readmissions, and emergency department overuse.
- Innovative healthcare delivery and payment models are needed to address these challenges.
Purpose of the Study:
- To describe the Centers for Medicare and Medicaid Services (CMS)-funded Coordinated Health Care for Complex Kids (CHECK) program.
- To present CHECK as an innovative healthcare delivery system designed for CMC.
- To highlight the program's goal of improving care quality and coordination for CMC.
Main Methods:
- The CHECK program utilizes a blend of high-tech and low-tech interventions.
- It focuses on connecting patients, stakeholders, and healthcare providers.
- The model aims to provide comprehensive and coordinated services.
Main Results:
- Anticipated outcomes include improved quality of care for CMC.
- Expected results involve a reduction in unnecessary inpatient hospitalizations, readmissions, and emergency department visits.
- The program is projected to achieve total cost savings.
Conclusions:
- The CHECK program offers a promising model for delivering improved, comprehensive, and coordinated care to CMC.
- It has the potential to reduce healthcare utilization and associated costs.
- This initiative can inform future cost-effective healthcare models for CMC and their families.
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.
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