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.
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.
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.
This conversation 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.
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.
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.
Many of the Medicare policies proposed in the federal CHRONIC Act of 2017 would benefit children and youth with special health care needs if they were adopted by state Medicaid programs.
Learning social skills is a cumulative, lifelong task that can have a profound effect on many aspects of an individual’s life. Social skills can be taught and reinforced at all ages and in numerous social settings. Greater attention to supporting the kinds of social interactions that improve relationships can contribute to individual growth and a more equitable and just society.
In May 2017, the National Health Law Program brought together stakeholders from around California to discuss potential legal interventions to improve access to mental health services for children with special health care needs. This fact sheet summarizes their recommendations for action.
Evidence shows that to create a high-quality health care system, the family perspective must be actively pursued and incorporated at all levels -- direct care, organizational design and governance, and policymaking. A new fact sheet outlines the value of family engagement and the barriers that prevent its implementation, along with recommendations for improvement.
