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Care Management for Children with Special Health Care Needs:. Addressing and Financing an Unmet Need May 30, 2007. April 17, 2006. Project Partners. Maternal Child Health Bureau Study period: July 1, 2002 – June 30, 2006

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care management for children with special health care needs

Care Management for Children with Special Health Care Needs:

Addressing and Financing an Unmet Need

May 30, 2007

April 17, 2006

project partners
Project Partners
  • Maternal Child Health Bureau
    • Study period: July 1, 2002 – June 30, 2006
  • Children’s Hospital & Regional Medical Center (CHRMC) – Center for Children with Special Needs
    • John Neff, MD
    • Virginia Sharp, MA
    • Jean Popalisky, RN, MN
  • Regence BlueShield
    • Tracy Fitzgibbon, RN
    • Kristin Myers
key learning points
Key Learning Points
  • Health plan case management activities and primary care case management activities are unique
  • Primary care providers identify, contact, and engage patients more efficiently and effectively than health plan
  • Both settings produce short-term cost savings from different sources
cooperative program
Data sharing between health plan and providers to mutually identify and classify population

Develop family centered care plan as evidence of care management activity

Demonstrate level of service that results in a higher quality outcome

Mutually determined performance measures

Cooperative Program
recommendations
Recommendations
  • Comprehensive care coordination for the families should integrate the unique case management activities from the health plan and primary care into a single, cooperative effort