CARE Award

The CARE Award study is an ambitious, national, pediatric population management project to improve quality and reduce cost of care for children with medical complexity. 

In partnership with 10 of the nation’s leading children’s hospitals, the Children’s Hospital Association received a three-year $23 million Health Care Innovation Award (HCIA) in round two from the Center for Medicare and Medicaid Innovation (CMMI) to test coordinating all resources effectively (CARE) for children with medical complexity, two-thirds of whom are covered by Medicaid.

This project aims to inform sustainable change in health care delivery through new payment models supporting better care, smarter spending and healthier children.

CMS approves carryover funding

The Centers for Medicare & Medicaid Services (CMS) approved a reallocation of unused funds from the previous project year to the final year of the project. This means the more than 50 hospital and primary care based sites can continue their important work in transforming care for more than 8,000 children with complex medical conditions. This funding is critical to support continued data analysis needed for project outcome measurement and a proposed project extension that will allow participating sites to sustain their improvements. View adjusted timeline.

Featured resources

Mar. 2017

Building Data to Manage a Pediatric Population
Details and specifications of a novel data and informatics framework, and lessons learned for sustainability of similar future efforts. 

Jan. 2017

Lessons Learned in the First 18 Months of the CARE Award
Early key findings in this three-year project to test change concepts to improve care and reduce costs for children with medical complexity.

July 2016

5 ways to Build Primary Care Physician Relationships
Hospitals participating in the CARE award share their insights on developing effective primary care physician relationships. 

April 2016

Implementing Delivery System Transformation
A summary of the progress during the second year of the CARE Award to implement delivery system changes.

October 2015

CARE Award: Early Lessons Learned 
An early look into what delivery system transformation takes. 

Project status

As we wrap up year three of the award, teams are focused on process implementation to make a measurable difference in care for the patients and families, and achieve results in spending and utilization.  This work will position participating children’s hospitals for further sustainability and strengthen the justification to transform care and align Medicaid payment design. 


Outcomes metrics

Family Functioning
Family function, as measured by the Pediatric Quality of Life (PedsQL) survey, is one metric contained within the patient experience survey as an indicator of quality of care during care transformation. 

Reflects the number of emergency department visits avoided among the enrolled patient population during the implementation of change concepts.  

Reflects the number of patient days avoided among the enrolled patient population during the implementation of change concepts.

PROCESS metrics*

Patient enrollment as of Dec. 2016
The enrollment goal is set collectively across all sites and is targeted to be achieved by Nov. 2016 to enable attribution of the change concepts to the enrolled population over time.
Patients Surveyed
Seventy-seven percent of those completing the baseline survey completed the first follow-up survey. The patient experience survey is an essential outcome measure of patient/family experience and burden.  A baseline survey should be completed once consented and every following six months.

QI Metrics
Hospitals with Claims Data
MCOs provide three-year historical claims data to the Award data vendor, IBM Watson (formerly Truven), which standardizes the data to produce utilization and spend analysis of the enrolled population.

Payment Models in Development
Sites work with the actuary vendor, Milliman, to analyze the utilization and spend reports to analyze options for value based payment models.

*Data as of April 2017 
CARE Goal Line graphic

This publication was made possible by Grant Number 1C1CMS331335 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.