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A Critical Analysis of Care Coordination Strategies for Children With Special Health Care Needs
Technical Reviews, No. 14
Investigators: Paul H Wise, MD, MPH, Lynne C Huffman, MD, and Gabriel Brat, BA.
Author Information and AffiliationsStructured Abstract
Objectives:
The goal of this technical review is to critically examine the issue of care coordination for children with special health care needs (CSHCN). Of particular interest is the knowledge base relating to those aspects of care coordination for CSHCN that are of greatest importance to current practice and policy challenges.
Review Methods:
A structured search and review of the literature was conducted to address the following issues: (1) analytic approaches and definitions used for care coordination strategies for CSHCN; (2) evidence for best practices of care coordination for CSHCN; and (3) evidence for the impact of managed care for CSHCN enrolled in Medicaid.
Results:
Among the principal findings are: (1) despite considerable progress in defining care coordination and CSHCN, there remains considerable variation in current analytic approaches and definitions; (2) some progress has been made in developing care coordination strategies for CSHCN; (3) there is a major need to evaluate the impact of these strategies on health outcomes and costs; (4) continued progress in care coordination for CSHCN may depend upon the replication and evaluation of promising strategies in different practice settings and under different reimbursement policies; (5) the constructive assessment of enhanced care coordination programs in managed care systems would be facilitated by new, more focused metrics and performance measures; (6) there is little evidence regarding the impact of managed care systems on CSHCN enrolled in Medicaid.
Recommendations:
Among the principal recommendations are: (1) increase support for efforts to identify in a standard manner CSHCN in large administrative or clinical datasets; (2) expand efforts to evaluate care coordination interventions for CSHCN, particularly in managed care settings; (3) develop capacity and performance standards of direct relevance for CSHCN for managed care plans; (4) link development of care coordination programs for CSHCN to emerging practice and health system reforms.
Contents
- Preface
- 1. Introduction
- 2. Review of Analytic Approaches and Definitions
- 3. Assessing the Impact of Care Coordination for CSHCN
- 4. Systematic Review of the Impact of Managed Care on Children With Special Health Care Needs: A Special Focus on Medicaid
- 5. Summary and Recommendations
- Appendix A Summary of Quality Assessment Criteria*
- References
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.1 Contract No. 290-02-0017. Prepared by: Stanford University-UCSF Evidence-based Practice Center, Stanford, CA.
Suggested citation:
Wise PH, Huffman LC, Brat G. A Critical Analysis of Care Coordination Strategies for Children With Special Health Care Needs. Technical Review No. 14. (Prepared by the Stanford University—UCSF Evidence-based Practice Center under Contract No. 290-02-0017.) AHRQ Publication No. 07-0054. Rockville, MD: Agency for Healthcare Research and Quality.
This report is based on research conducted by the Stanford-UCSF Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0017). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.
This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.
The investigators do not have any affiliations or financial involvements that conflict with the material presented in this report.
- 1
540 Gaither Road, Rockville, MD 20850. www
.ahrq.gov
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