Aligning Services with Needs: Characterizing the Pyramid of Complexity Tiering for Children with Chronic and Complex Conditions
As health care and financing systems become more sophisticated, health care systems are increasingly using a process known as "risk tiering" to group patients with similar degrees of need for health care and care coordination services. Payers are becoming part of this conversation, which for children is in its very early stages. Families and care providers of children with chronic and complex conditions should understand the risk tiering process, as it may affect access to services these children need.
This new report from a group of national experts describes current tiering practices and uses, and makes recommendations for policy and research, particularly as the process relates to children with special health care needs.