University Hospitals Rainbow Care Connection Transforms Health Care for Babies and Children

UH Rainbow Care Connection is one of the first pediatric accountable care organizations (ACOs) in the country. University Hospitals Rainbow Babies & Children’s Hospital received a $12.7 million Health Care Innovation grant from the Center for Medicare & Medicaid Innovation for its Physician Extension Team (PET).* To effectuate this grant, UHACO created a Pediatric ACO called UH Rainbow Care Connection, to create a physician network that will help to manage the health of 200,000 children in northeast Ohio, one-third of whom are Medicaid enrollees. Through the Rainbow PET’s clinical programs and employees and the UH Rainbow Care Connection Network and sustainability efforts, our pediatric ACO creates meaningful relationships across patients, pediatric primary care providers, hospitals and managed care organizations to drive change and achieve three main objectives:

  • Better care
  • Better health
  • Lower costs

Transforming Pediatric Care

Through the UH Rainbow Physician Extension Team at UH Rainbow Babies & Children’s Hospital, and as part of the grant from the Center for Medicare and Medicaid Innovation, we have developed the following clinical programs:

  • Increasing primary care provider adherence to evidence-based national quality measures
  • Improving the care and health of children with complex chronic conditions through an innovative program that coordinates comprehensive care
  • Improving access and coordination of behavioral health services
  • Decreasing avoidable emergency department visits and hospitalizations

Improving Quality of Health Care

The UH Rainbow Care Connection Network integrates the clinical services of the UH Rainbow Physician Extension Team (PET) with primary care providers (PCP), hospitals, managed care and behavioral health and community agencies to improve the quality of health care for the children of northeast Ohio at significantly reduced costs to the health care system.

Our pediatric ACO model represents an innovative way to deliver integrated care and can be easily replicated nationally with high impact savings to Medicaid and other insurance systems.

Overall Improvement in Health Care Delivery System

UH Rainbow Care Connection changes the health care delivery system for all pediatric patients and improves child health overall. Using the

PET model, we have developed a coordinated system that gives families benefits such as:

  • Improved quality of outpatient care for children
  • Increased access to physicians
  • Improved access to pediatric behavioral health services
  • Decreased unnecessary emergency visits and hospitalizations
  • Improved health and functionality of children with complex chronic conditions

UH Rainbow Care Connection Programs

UH Rainbow Care Connection Network consists of 120 to 140 primary care pediatricians from across northeast Ohio. Physicians are eligible to receive incentive payments for improving quality of care, access and care coordination for their patients. Other clinical programs include:

*The project described is supported by Funding Opportunity Number CMS-1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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