Increasing Access in an Accountable Care Organization :: Nationwide Children's Hospital

Increasing Access to Care through our Physician Hospital Organization


Medicaid reimburses physicians at a rate that is just 76 percent of what Medicare pays, well below the cost of providing care. As a result, many physicians cap the number of Medicaid patients they will see, and an increasing number have stopped taking Medicaid patients altogether.

As the first step in creating one standard of care, Nationwide Children’s Hospital has focused on increasing access to primary and specialist pediatric care for children within its 37-county primary service region.

Nationwide Children’s Primary Care Network

  • Nine primary care facilities located in underserved areas of Columbus, Ohio, where no community pediatricians operate.

  • Responsible for the primary care of more than 70,000 patients.

Increasing Physician Access in Medicaid

Nationwide Children’s Partners for Kids physician hospital organization operates as a key part of an Accountable Care Organization, paying network physicians at a rate preferential to Medicaid and assuming the business risk for clinical and financial outcomes.
 

Increase in the number of Partners for Kids primary care physiciansPartner for Kids has:

1. Developed a network in areas of low penetration.

2. Increased contracting and access in rural and outlying areas through preferential rates.
 

The outcomes are:

  • Increase in capacity to accept Medicaid patients amongst Partners for Kids' physicians

    A more than threefold increase in the number of physicians in the network over the past decade, from 109 to 334 physicians.

  • More physicians agreeing to accept additional Medicaid patients, an increase in capacity of over 300,000 patients.

  • Additional Medicaid Managed Care contracts.

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000