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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
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Related Experiment Video

Updated: Dec 25, 2025

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
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Costs and Use for Children With Medical Complexity in a Care Management Program.

David A Bergman1, David Keller2, Dennis Z Kuo3

  • 1Department of Pediatrics, School of Medicine, Stanford University, Stanford, California; daberg@stanford.edu.

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|April 2, 2020
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Summary
This summary is machine-generated.

A care management program significantly reduced healthcare spending and emergency visits for children with medical complexity. This demonstrates a cost-saving opportunity in pediatric healthcare.

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Area of Science:

  • Pediatric Healthcare Management
  • Health Economics
  • Complex Care Coordination

Background:

  • Children with medical complexity (CMC) represent a significant portion of pediatric healthcare costs.
  • Targeting CMC populations offers substantial opportunities for healthcare cost savings.
  • Effective care management programs are crucial for optimizing resource utilization in this demographic.

Purpose of the Study:

  • To evaluate the impact of a multicenter care management program on healthcare spending and utilization among CMC.
  • To assess the cost-effectiveness of coordinated care interventions for pediatric patients with complex medical needs.

Main Methods:

  • Prospective cohort analysis of 4530 CMC enrolled in a learning collaborative.
  • Utilized 3M Clinical Risk Group categories for patient identification (ages 0-21).
  • Employed 1:1 propensity score matching and statistical process control for outcome analysis.

Main Results:

  • A 4.6% decrease in total per-member per-year spending was observed.
  • Significant reductions in inpatient (7.7%) and emergency department (11.6%) spending were noted.
  • Statistical process control confirmed decreased hospitalization rates and emergency department visits.

Conclusions:

  • Enrollment in a learning collaborative care management program led to significant reductions in healthcare spending for CMC.
  • The program demonstrated a decrease in hospitalizations and emergency department visits.
  • Further research is required to confirm long-term sustainability and replicability of these findings.