Care Management for Children with Special Health Care Needs:

1. Care Management for Children with Special Health Care Needs: Addressing and Financing an Unmet Need May 30, 2007 April 17, 2006

2. 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

3. Health Plan Activities

4. Primary Care Activities

5. 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

6. 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

7. 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