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    Families of Children With Medical Complexity: A View From the Front Lines

    Families authentically involved at every level of health care systems are critical partners in designing policies and systems that will improve care for children with medical complexity. Written by a group of parents, this article provides an overview of the demands of managing care from their unique perspective.

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    Models of Care Delivery for Children with Medical Complexity

    Novel care delivery models in which care coordination and other services to children with medical complexity are provided are a focus of national and local health care and policy initiatives. This article explores the rapid proliferation in the creation of new models and examines their unique advantages and disadvantages.

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    Status Complexicus? The Emergence of Pediatric Complex Care

    Increased attention to children with medical complexity has occurred because these children are growing in impact, represent a disproportionate share of health system costs, and require policy and programmatic interventions that differ in many ways from broader groups of children with special health care needs. As an emerging field, pediatric care systems should thoughtfully and rapidly develop evidence-based solutions to improve care.

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    Care Coordination for Children with Medical Complexity: Whose Care Is It, Anyway?

    Dedicated care coordination is increasingly seen as key to addressing the fragmented care that children with medical complexity often encounter. Authors discuss the need for infrastructure building, design and implementation leadership, use of care coordination tools and training modules, and appropriate resource allocation under new payment models.

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    Ethical Framework for Risk Stratification and Mitigation Programs for Children with Medical Complexity

    Designing clinical programs for children with medical complexity often includes the need to implement a system of risk stratification. Authors use the framework of an ethical evaluation of a health care program to examine what the task of risk stratification might entail and provide recommendations to help ensure that programs avoid potentially ethically problematic situations and practices.

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    Supporting Self-Management in Children and Adolescents with Complex Chronic Conditions

    Self-management improves health outcomes in chronic illness not only by improving adherence to the treatment plan but also by building the individual’s capacity to navigate challenges and solve problems. This article discusses the need for clinicians to have standardized approaches and tools to assess and promote self-management for youth and adolescents.

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    Aligning Services with Needs: Characterizing the Pyramid of Complexity Tiering for Children with Chronic and Complex Conditions

    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. 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 report outlines how tiering currently is being used, and makes recommendations for policy and research. 

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    How Interagency, Cross-Sector Collaboration Can Improve Care for CSHCN: Lessons from Six State Initiatives

    Children and youth with special needs are best served through a coordinated approach across the myriad programs and agencies whose services they need.  In two new reports, Health Management Associates highlights how six programs in five states have made progress in overcoming the frustrating barriers to interagency collaboration among programs that serve these children and their families. The reports offer recommendations on how states might foster efforts to improve communication and coordination across programs and reduce fragmentation and duplication of services. 

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