Paul Vaughan, MD, has been appointed medical director of Partners for Kids (PFK), the physician hospital organization (PHO) affiliated with Columbus Children’s Hospital.
“Partners for Kids has experienced significant growth, increasing pediatric membership from 60,000 members in early 2006 to currently more than 170,000 Medicaid-covered kids in central and southeast Ohio,” said John Hamilton, PFK executive director and vice president for Payor Relations at Columbus Children’s. “With this growth comes the need to expand our capacity to execute our overall Medicaid strategies. PFK is well positioned for success and Dr. Vaughan’s experience and leadership in managed care will provide the support we need as our PHO continues to grow and expand our reach into the outlying county service area.”
Vaughan completed his medical education at Temple University School of Medicine and earned his Master’s Degree in Public Health from the University of Pittsburgh. He is board certified in Emergency Medicine, a Fellow in the American College of Emergency Physicians and a licensed practitioner in Ohio, Indiana, Michigan and Pennsylvania. Vaughan has an extensive background in managed care and quality improvement, having held various leadership positions with commercial, Medicaid managed care and insurance organizations. Most recently, he served as the medical director of Molina Healthcare of Ohio, one of PFK’s contracted health plans and one of the larger Medicaid organizations in the country.
The PFK provider network offers a comprehensive range of pediatric health care services through contracts with both commercial and Medicaid managed care organizations and service providers. PFK is composed of Columbus Children’s Hospital and more than 550 pediatricians, family practice, and pediatric and adolescent specialty providers located in central and southeast Ohio responsible for approximately 170,000 children and young adults through managed care agreements. As the state of Ohio continues to roll out Medicaid Managed Care expansion, PFK enrollment is expected to approach 250,000 pediatric Medicaid recipients early in 2007. To date, the organization has worked almost exclusively with the Medicaid population in conjunction with the State of Ohio Medicaid Managed Care Program and it’s contracted Medicaid Managed Care Health Insuring Corporations (HICs). Working collaboratively with clinical
providers and contracted HICs, PFK utilizes innovative strategies to improve quality, access, preventive services and disease management for the children covered under managed care agreements, offering an alternative to traditional health plan/provider contracting, and promoting a comprehensive, community-based approach to health care service delivery.
PFK’s 10-year contract with CareSource, the State of Ohio’s largest Medicaid HIC, was recently renewed. PFK now contracts with each of the Medicaid HICs in the central and southeast Ohio markets, including Anthem BCBS, CareSource, Molina Healthcare of Ohio, and Unison Health Plan. Together, these four contracts give PFK access to all pediatric and adolescent Medicaid managed care recipients enrolled in the state’s Medicaid Managed Care programs. These contracts mean that any Medicaid recipient can benefit from access to any of PFK’s affiliated providers, including all of Columbus Children’s Hospital’s services, regardless of what health plan they select.
NOTE TO EDITOR: Vaughan is a resident of Columbus, Ohio 43235. He relocated to Columbus after living in Mt. Lebanon, PA, for more than 22 years.