Estimating Costs to Manage Care for Children with Complex Medical Conditions

To facilitate discussions with payers, states and managed care organizations, estimate the cost of providing care to a population of children with complex medical conditions in a medical home.

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Understanding the costs of care management will assist hospitals in accounting for resources to provide care transformation, and accurately forecast financial risk. This will then facilitate external discussions with payers, states, and managed care organizations to attain the most ideal payment model for all parties.

This white paper estimates the cost of providing care management services to a population of 600 children with complex medical conditions in a medical home.

CARE Award Children With Medical Complexity Operational Improvement Payment Models