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Health care collaboration to improve care for North Carolina's most fragile children

Health care collaboration to improve care for North Carolina's most fragile children

Health Care Collaboration to Improve Care for North Carolina's Most Fragile Children

RALEIGH, N.C. -- September 20, 2012 -- Community Care of North Carolina (CCNC), the award-winning program that provides medical homes to 1.2 million North Carolinians, has been awarded a three-year grant from the Centers for Medicare and Medicaid Innovations Center (CMMI) to implement the “Child Health Accountable Care Collaborative” (CHACC). The program is an effort to improve care for children with complex medical conditions through close cooperation between North Carolina hospitals, primary care providers, and subspecialists. Improving coordination of services to high-risk children is expected to lead to better outcomes, lower costs and improved patient experience.

CCNC is one of only 107 institutions across the country to receive funding through the highly competitive CMMI solicitation. The $9.3 million CMMI grant is expected to produce health care savings of approximately $24 million over the life of the grant.

The Collaborative is built on a pioneering partnership between CCNC, the academic medical centers at Carolinas Medical Center-Charlotte, Duke University Health System, University of North Carolina Hospitals, Vidant Medical Center-East Carolina, and Wake Forest Baptist Health, and the children’s units at Cape Fear Valley Health, CMC Northeast, Cone Health, Mission Hospital, New Hanover Regional Medical Center, Presbyterian Healthcare, and WakeMed Hospitals.

“The goal of the Children’s Care Collaborative is to improve access to care and quality of life for the Medicaid and CHIP children served,” said Steven Wegner, MD, Board Chair, CCNC. “Collaboration between previously unaffiliated providers will reduce duplication and help break down the fragmentation of care these children and their families often experience when transitioning from inpatient to home-based care.”

CHACC will target pediatric patients with multiple co-morbid conditions, with an emphasis on the highest-risk patients receiving care from pediatric subspecialists at children’s hospitals or tertiary care hospitals in North Carolina. A significant number of these patients are infants in neonatal or pediatric intensive care units who are at high risk of readmission due to their fragile health status.

Built on the medical home concept, Community Care of North Carolina matches each patient with a primary care provider who leads a health care team that addresses the patient’s individualized health needs. The Child Health Accountable Care Collaborative will leverage CCNC’s existing infrastructure and expand the scope of the Medical Home, improving co-management and shared responsibility between subspecialty providers and primary care providers.

CMMI grant funds will allow CCNC to embed children’s specialty care managers in hospitals and specialty clinics to work closely with primary care providers. Patient Coordinators will provide additional assistance to families navigating the complex medical services needed by these fragile children. These supports aim to promote more coordinated and effective use of health care services.

“CHACC is evidence that the founding principles of better management of care through medical homes work for our most challenging patients, said Bill Pully, President, North Carolina Hospital Association. “Nowhere else is prevention and the heightened involvement by primary care physicians and specialists more important or more effective in reducing the cost of health care. CCNC and its programs define value for targeted populations. Better coordination of care for fragile pediatric patients will most importantly lay foundations for these children to lead healthier lives. Hospitals across the state are proud to participate with CCNC in this initiative.”

The projected $24 million in savings will be achieved primarily through reductions in avoidable emergency room visits, hospitalizations, and pharmacy costs.

Over the three-year grant period, Community Care of North Carolina will train an estimated 42 workers and will create an estimated 44 jobs. The new workforce will include children's specialty care managers and patient coordinators.

The CMS Innovation Center is funding up to $1 billion in grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health Insurance Program (CHIP), particularly those with the highest health care needs. The program began on July 1, 2012.

The project described was supported by Funding Opportunity Number CMS-1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.”

About Community Care of North Carolina

CCNC is a community-based, public-private partnership that takes a population management approach to improving health care and containing costs for North Carolina’s most vulnerable populations. Through its 14 local network partners, CCNC creates “medical homes” for Medicaid beneficiaries, individuals eligible for both Medicare and Medicaid, privately-insured employees and uninsured people in all 100 counties.