One of the nation’s oldest and largest pediatric accountable care organizations, Partners For Kids is a partnership between Nationwide Children’s Hospital and more than 1,000 doctors, and is an extension of Nationwide Children’s long-standing mission of serving all children regardless of their ability to pay.
As an accountable care organization, Partners For Kids brings together health care providers to offer high-value, coordinated care to a defined patient population. Partners For Kids acts as a bridge between the state’s five Medicaid Managed Care Plans and the actual care that approximately 330,000 children in central and southeastern Ohio receive under those plans.
Since its founding in 1994, Partners For Kids has proven that it can provide high-quality care at a lower cost.
“Partners For Kids takes the traditional focus on health care and shifts it to a focus on children’s overall health. It is the premier innovative pediatric health care delivery model in the country.”
- Nick Lashutka, president of the Ohio Children’s Hospital Association
Physician incentives for quality care, better drug prescription practices, care coordination and a focus on illness prevention have led to cost savings and better care for children.
Physicians are incentivized on target areas of child health that need to be improved. One example is through adolescent well-child visits, key for keeping children healthy. Many adolescents are not scheduling these exams. Taking it a step further, the organization will send physicians call lists for patients due for visits. Partners For Kids staff members will even travel to physician offices to help them schedule wellness appointments.
Care coordinators assist children with medical complexity and their families to navigate uneventfully, efficiently and as effectively as possible through the health care system. Data from 2014 show that patients enrolled in care coordination for at least 120 days saw hospital inpatient admissions and emergency department visits decrease.
Partners For Kids’ Pharmacy Program works to hold down prescription costs in several ways while still providing patients with the medication they need.
Partners For Kids pharmacists provide guidelines to physicians who may be unaware that some medications are less expensive, more effective or more widely covered by health plans than others.
The Pharmacy Program works with the Medicaid Managed Care Plans to give patients better access to certain treatments that the plans do not already cover, and provides information that allows the plans to save money even outside of Partners For Kids. For example, the antipsychotic medication Abilify® is priced by pill, not by strength of dose. Two 5 milligram pills of Abilify® cost nearly twice the amount of one 10 milligram pill. Abilify® is long acting, so the single 10 mg pill is just as effective. If all Partners For Kids patients currently on Abilify® took just one dose per day, the potential savings is more than $350,000 per year.
All of these cost savings programs have led to steady or improving measures of quality care and patient outcomes.
“Ohio’s focus is on value – quality care at a sustainable cost. We want to create an environment where every provider is on a path to value arrangements. It is very helpful to have Partners For Kids as an example we can point to of an organization that has done it the right way.”
- Greg Moody, director of the Governor’s Office of Health Transformation
To get the best outcomes possible, Nationwide Children’s and Partners for Kids the importance of keeping children healthy in their neighborhoods and schools.
Some community programs and services that have benefitted directly from Partners For Kids savings include: