UH News

University Hospitals Rainbow Babies & Children’s Hospital receives $12.7 million Health Care Innovation Award

Tuesday, May 8, 2012

Proposed Health Care Delivery Model to Transform Care for Children in the U.S.

Cleveland, Ohio – University Hospitals Case Medical Center’s Rainbow Babies & Children’s Hospital (UH Rainbow) will receive $12.7 million of the $122.6 million awarded by the Centers for Medicare and Medicaid Innovation (CMMI) this week for sustainable plans to improve care, lower costs and improve the overall health and wellness of children. UH Rainbow is among 26 other preliminary awardees announced today to receive a federal Health Care Innovation Award from more than 3,000 applicants nationwide.

The Centers for Medicare and Medicaid Services (CMS) opened a grant competition late December of 2011 for ideas that can deliver quick benefits to the Medicare and Medicaid program in terms of cost savings and higher-quality care. The competition called the Health Care Innovation Award, funded by the 2010 Patient Protection and Affordable Care Act, will provide three-year grants of $1 million to $30 million to health care providers, payers, local government entities, and public-private partnerships, including collaborative efforts among multiple payers.

UH Rainbow submitted a proposal to deliver CMMI’s three goals – better health, improved care, and lower costs – through the implementation of a multidisciplinary workforce that the children’s hospital calls the Physician Extension Team (PET). The PET model is designed to create collaborations with primary care providers, hospitals and managed care and health educators in order to provide children with the highest quality of care at significantly reduced costs to the health care system.

“We are changing the health care delivery system for all pediatric patients and improving child health overall,” said Leona Cuttler, MD, UH Rainbow’s Director of the Center for Child Health and Policy, Chief of Pediatric Endocrinology, Diabetes and Metabolism and Professor of Pediatrics at Case Western Reserve University School of Medicine. “Our goal with the PET model is develop a sustainable coordinated system that improves the quality of outpatient care for children, increases their access to physicians, improves pediatric behavioral health services, decreases unnecessary emergency visits and hospitalizations and advances the health and functionality of children with complex chronic conditions.”

UH Rainbow’s PET model will target over 68,000 children with Medicaid insurance as well as include children with other insurance in several counties across northeastern Ohio.

The PET Model includes three core programs:

Practice-tailored Facilitation: Health care professionals will provide customized education, training, and enrollment in quality improvement initiatives to primary care offices. PET will collaborate with primary care physicians to improve access.

Telehealth: The PET program will provide 24/7 access to nurses and physicians who provide advice, referrals, and care coordination through an extensive system of telephone triage, community-based telehealth facilities and instant alert devices that connect homes to on-call personnel.

Support Services: Multidisciplinary teams including health care professional advocates will assist primary care physicians in providing their patients with medical evaluations and home-based assessments, mental health support as well as align social services.

“We believe this new model will provide better health care at a more appropriate level,” said Andrew Hertz, MD, Medical Director for the UH Rainbow Care Network and Assistant Clinical Professor at Case Western Reserve University School of Medicine. “The PET model represents an innovative way to deliver integrated care and we believe it can be easily replicated nationally with high impact savings to the Medicaid and other insurance systems,” added Dr. Hertz “All children receive a greater level of care and their primary care physician maintains overarching care coordination.”

The PET model will be implemented in stages during the course of six months. More than 50 health professionals will be either hired or trained to implement the PET model.

The preliminary awardees announced today expect to reduce health spending by $254 million over the next three years.

“We can’t wait to support innovative projects that will save money and make our health care system stronger,” said Health and Human Services Secretary Kathleen Sebelius. “It’s yet another way we are supporting local communities now in their efforts to provide better care and lower cost.”

Preliminary awardees were chosen not only for their innovative solutions to the health care challenges facing their communities, but also for their focus on creating a well-trained health care workforce that is equipped to meet the need for new jobs in the 21st century health system.

The Bureau of Labor Statistics projects the health care and social assistance sector will gain the most jobs between now and 2020.

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