Families of children with medical complexity often have to manage care plans that include professional supports across multiple sectors - specialty and primary care, school, pharmacy, and home care among others. While many children's hospitals have developed unique CMC care coordination services, most struggle to identify financially viable approaches to sustaining these critical services to enhance both the model delivery and payment approach to CMC services.
Working in collaboration with clinicians and state Medicaid staff, a unique payment model was developed that will support the expansion of care coordination services for CMC. The program now serves nearly 5 times the children and families as the original model in a manner that is financially sustainable.
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