142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

310672
Medicaid expenditures for children with complex healthcare needs: A care coordination model evaluation

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Steven Howard, PhD, MBA , College for Public Health and Social Justice - Department of Health Management & Policy, Saint Louis University, St. Louis, MO
Lindsey Pearson, BS , College for Public Health and Social Justice - Department of Health Management & Policy, Saint Louis University, St. Louis, MO
Christine Buelt, Bachelor of Science in Biology , College for Public Health and Social Justice - Department of Biostatistics, Saint Louis University, St. Louis, MO
Zidong Zhang, MS , College for Public Health and Social Justice - Department of Biostatistics, Saint Louis University, St. Louis, MO
Samantha Ressler, MPH , College for Public Health and Social Justice - Department of Health Management & Policy, Saint Louis University, St. Louis, MO
Matt Dietz, BS , College for Public Health and Social Justice - Department of Health Management & Policy, Saint Louis University, St. Louis, MO
Roy Lantry, Master of Business Administration , Department of Health Management and Policy, Saint Louis University College for Public Health and Social Justice, St. Louis, MO
Background:

Complex medical conditions persist in vulnerable pediatric populations.  Ranken Jordan Pediatric Bridge Hospital developed a model of care to address this population’s special needs.  Their “Care Beyond the Bedside” model is unique to the organization, and its efficiency and effectiveness need to be validated empirically.  The purpose of this study is to compare longitudinal cost and utilization for Ranken Jordan patients with patients receiving usual care at other facilities.

Methods:

Using 2007-2012 Missouri Medicaid data, descriptive analyses were performed for medically complex children.  The intervention group (n=147) comprised patients fitting eight clinical profiles served by the Care Beyond the Bedside model.  Controls were clinically similar patients (n=1947) served by traditional models of care at other organizations.  Regression models were developed to further analyze the data.  The dependent variables in the models are longitudinal cost of care and emergency department and inpatient utilization, with clinical profile and treatments as explanatory variables of interest.

Results:

Preliminary results demonstrate greater expenditures, hospitalizations and emergency department utilization for the control group.  

Conclusions:

Our findings support the hypothesis that the Care Beyond the Bedside model reduces healthcare spending and acute care utilization.  Incorporating the Care Beyond the Bedside model in other states could result in reductions in state and federal Medicaid spending.  The results of this study contribute to the conversation on best practices for children with complex medical conditions.  Future research interests include expanding the study to other parts of the country and to other hospitals serving similar patient populations.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Define the Ranken Jordan “Care Beyond the Bedside” model and explain how the model results in lower longitudinal cost and inpatient and emergency department utilization when compared to usual models of care.

Keyword(s): Pediatrics, Children With Special Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Lindsey Pearson is a Master of Health Administration student at Saint Louis University. She graduated from Missouri State University with her Bachelor of Science in Management. Her research to date has included contributions to studies on health disparities, Medicare Advantage and disease outcomes, and pediatric hospital models. Lindsey's career interests are in pediatric hospital administration.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.