In September 2014, the Pediatric Complex Care Program at American Family Children’s Hospital (AFCH), in conjunction with the State of Wisconsin Department of Human Services and Children's Hospital of Wisconsin Special Needs Program, received a three-year, $9.45 million Centers for Medicare and Medicaid Services Innovation Award.
The award supports further development of the program’s mission of care coordination for children with medical complexity.
Mary Ehlenbach, MD, is the program’s medical director; Ryan Coller, MD, MPH, is its research director.
Children who may be eligible for the Pediatric Complex Care Program have multiple medical conditions (defined as affecting at least three organ systems and requiring the care of three or more medical or surgical subspecialists) and have had high healthcare utilization in the past year (at least 5 days in the hospital or at least 10 specialty clinic visits).
Children with medical complexity cared for by the program typically have significant cognitive and functional impairments, and depend on feeding tubes, central lines, shunts, or other medical technologies. They may have been born prematurely, survived critical illness, or have cerebral palsy, rare genetic disorders, or multiple congenital anomalies.
Since opening in March 2014, the program has already enrolled 55 patients, and hopes to serve several hundred by the end of the grant period.
CMS Health Care Innovation Awards support the implementation of 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 patients with the highest health care needs.