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    Evolving Federal and State Health Care Policy: Toward a More Integrated and Comprehensive Care-Delivery System for Children with Medical Complexity

    Alternative payment models promote novel care-delivery systems and greater accountability for health outcomes With a focus on population health, patient-centered medical homes, and care coordination, this model holds the potential to promote care-delivery systems that address the unique needs of children with medical complexity, including nonmedical needs and the social determinants of health.

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    Protecting Rights of Children with Medical Complexity in an Era of Spending Reduction

    Sufficient access to needed services for children with medical complexity is not assured and varies considerably by payer, many of whom who face pressures to control health spending. This article reviews the rights of children with medical complexity in Medicaid, the Children’s Health Insurance Program, and various forms of private health insurance to receive services that are necessary to promote optimal health, development, and family functioning.

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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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    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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