Saving Money by Improving Health for our Most Vulnerable Children
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 at a Glance:
- 330,000 children cared for
- 34 counties in central and Southeastern Ohio served
- More than 1,000 doctors participate
“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
High Value, High Quality Care
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.
Physician Incentive Program
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.
Measures of Success
All of these cost savings programs have led to steady or improving measures of quality care and patient outcomes.
Asthma patients visits to the Emergency Department decreased almost every month in 2015 from comparable months in 2012-2014.
The number of days patients with certain neurologic diagnoses, such as cerebral palsy who also have a feeding tube, spent in the hospital per month dropped significantly from the beginning of 2011 to the end of 2014.
“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
Reinvesting in Child Health
To get the best outcomes possible, Nationwide Children’s and Partners For Kids understand the importance of keeping children healthy in their neighborhoods and schools.
Some community programs and services that have benefited directly from Partners For Kids savings include:
Integrating Professionals for Appalachian Children (IPAC): This rural health network works to increase well visits for teenagers, access to long-acting reversible contraceptives (LARC) and prenatal care for young mothers.
Chapter Quality Network Asthma Project: This program of the Ohio Chapter, American Academy of Pediatrics, helps pediatricians implement national guidelines to improve the care and outcomes of children with asthma.
School-Based Asthma Therapy: Children who enroll can receive this medication at school, and their parents can be trained to dispense the medication at home, which increases school attendance and decreases Emergency Department visits.
Welcome Home: The Welcome Home program from Nationwide Children’s helps teenagers with the transition after their behavioral health inpatient stays.
Partners For Kids Earns NCQA Certification in Credentialing
Partners For Kids has been certified by the National Committee on Quality Assurance (NCQA) in Credentialing. NCQA certification is a voluntary process that is governed by the Standards for Certification in Credentialing, developed with the assistance of representatives from NCQA’s Standards Committee, Review Oversight Committee, and input from other organizations.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers. NCQA has reviewed and certified Partners For Kids’ Credentialing functions only. For complete details on the scope of this review, visit www.ncqa.org