Partners for Kids (PFK), Nationwide Children’s Hospital and Akron Children’s Hospital were recently awarded a $13.1 million Health Care Innovation Grant from the Centers for Medicare and Medicaid Services (CMS). With support from the state of Ohio, these partners will expand the PFK model to cover a total of 517,000 Medicaid-enrolled children in 46 of Ohio’s 88 counties, covering the urban northeast area to the southern tip of the state, including rural central and southeastern Appalachian counties.
The expansion of the PFK model of health care delivery represents a new national innovation, a model not being tested anywhere else by the CMS.
Partners for Kids (PFK) is the largest and oldest accountable care organization focused solely on Medicaid-enrolled children in the nation. PFK contracts with area Medicaid managed care plans, which receive a set amount of money each month from the State of Ohio for the health care needs of each child covered. The plans then pass a dollar amount per child (also known as a capitated amount) onto PFK. PFK becomes responsible for covering all the health care needs of each child, regardless of where they receive care.
By receiving a set amount of funds for all the health care needs of a child, the PFK program incentivizes quality outcomes and prevention. To date, PFK has reduced neonatal intensive care unit length of stay, reduced the premature birth rate, decreased emergency room visits and increased immunizations for high-risk children.
The CMS Innovation Center is awarding up to $1 billion nationally in grants to organizations implementing the most compelling new ideas to deliver improved health care and lower costs to people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Expanding the Partners for Kids model was chosen as one of those compelling, innovative ideas.
“Ohio Medicaid welcomes the opportunity to partner with successful CMS Innovation Grant recipients to improve health outcomes while lowering the cost of health care,” said John McCarthy, Director, Ohio Medicaid. “Ohio is an important environment to identify and test new care delivery and payment models, and we look forward to working with Partners for Kids to expand an efficient, family-focused health delivery model that can be replicated throughout the country.”
“As the parent and convening organization for PFK, we are committed to the overall health of all children, especially those in underserved areas with the most challenging health conditions,” said Steve Allen, MD, CEO, Nationwide Children’s Hospital. “PFK’s exemplary model of collaboration between the State of Ohio, Medicaid managed care organizations and local communities has achieved striking results for child health improvements and cost savings in central Ohio. The expanded partnership with Akron Children’s Hospital and its integrated physician group is a catalytic step toward further transforming child health care delivery in Ohio.”
Specifically, the expanded PFK model will:
- Cover 517,000 children, including more than 200,000 Medicaid-enrolled children in the Akron and northeastern areas of Ohio.
- Cover 25,000 previously excluded disabled children who constitute a large portion of pediatric medical costs.
- Add a shared savings component that benefits patients, provider organizations, the State of Ohio and federal Medicaid programs.
- Rapidly deploy an expanded healthcare workforce with a focus on increasing access for high-risk rural and urban underserved populations.
- Evaluate health, quality of care and cost savings outcomes among PFK regions compared to historical trends and other areas of Ohio to determine the viability and replication of this care delivery model.
“We are proud to be a partnering health care system for this forward-thinking model of child health delivery,” said William Considine, President and CEO, Akron Children’s Hospital. “Akron Children’s, the Austen BioInnovation Institute in Akron and other community partners have worked together to expand access to quality care, improve the health of Medicaid-enrolled children and reduce health costs in northeast Ohio through the Accountable Care Community initiative. The expanded PFK model directly aligns with our goals, extending a positive impact on child health to more areas of the state, and serving as a model of care delivery for the nation.”
“Receiving this grant is a true validation of how organizations can work together to improve child health,” said Kelly Kelleher, MD, MPH, the project director for the grant and vice president of Community Health and Health Services Research at Nationwide Children’s. “Partners for Kids, together with Akron Children’s, Nationwide Children’s and their expansive networks of community physicians, will develop a more patient- and family-focused system of care that improves quality and access while saving costs. The partnership is a significant benefit for our state, but more importantly it is a remarkable move forward in the care of Medicaid-enrolled children and their families.”
Learn more about Partners for Kids at PartnersforKids.org.