Online Program

Achieving Medical Home Certification within a Coordinated Care Entity (CCE)

Wednesday, November 4, 2015 : 8:30 a.m. - 8:40 a.m.

Stephanie Pelligra, MPH, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
Alisa Abraham, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
Background: In response to a changing healthcare environment, Ann & Robert H. Lurie Children’s Hospital of Chicago has implemented several new models of care delivery to provide high value care. In 2014, Lurie Children’s was named one of two CCEs for children with complex medical needs in Illinois. Uptown Primary Care, one of Lurie Children’s primary care center at Lurie Children’s, is the medical home for pediatric patients with complex medical needs. To provide the highest quality coordinated care, Uptown applied for National Committee for Quality Assurance (NCQA) Patient Centered Medical Home Certification (PCMH).

Methods: Uptown has a long standing history of providing high-value care for its patients. PCMH certification has strengthened Uptown’s model of care coordination and quality improvement initiatives. As a result of the application, guidelines were expanded to include preventative care reminders for patient care plans in adherence with American Academy of Pediatric standards. Quality initiatives were created focused on patients with chronic illness or those who are highly medically complex.

Results:  Early data shows a 15.7% decrease in payments per Illinois Medicaid recipient compared to state averages for medically complex pediatric patients. In 2014, the number of patients who received their appropriate 15 month well child care visit increased by 6.3% and the number of patients with a documented asthma control test increased by 9%. In the same year, patients with ADHD tracked for appropriate follow up increased by 38.8%. 

Conclusions: The care delivery model at Uptown has proven to reduce healthcare costs, while improving outcomes.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related public policy

Learning Objectives:
Describe a medical home for medically complex pediatric patients. Demonstrate how to become a medical home within an academic institution. Evaluate the success of a medical home within a Coordinated Care Entity (CCE).

Keyword(s): Maternal and Child Health, Patient-Centered Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author on the content I am submitting because I have over 6 years of experience working in pediatric public health. My interests include medical homes, pediatric transition to adult care, clinical informatics, and program development and evaluation.
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.

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