Brian Hilligoss, assistant professor in the division of Health Services Management and Policy was published on NEJM Catalyst, along with his co-authors, for their case study on Partners for Kids, Nationwide Children’s Hospital’s accountable care organization (ACO).
The study, funded by the Patient-Centered Outcomes Research Institute, looked at how the ACO coordinates care for children with disabilities as part of its effort to improve the quality of care and reduce costs for this high-need pediatric population.
“This case study is important, in part, because it focuses on a particularly vulnerable population, children with disabilities covered under Medicaid, that hasn’t received much attention in health care reform efforts to-date,” said Hilligoss. “Many of these children have highly complex, resource-intensive health care needs that can be costly to provide and challenging to coordinate. This population has traditionally been exempt from managed care insurance models, largely owing to this complexity, but now many states are looking to move populations with disabilities into managed care arrangements, including new models such as the ACO.”
In 2013, it became a requirement that all children in Ohio that are in Medicaid’s Aged, Blind and Disabled (ABD) category enroll in Medicaid managed-care plans. A care-coordination program was then created to help meet the needs of the children under the plan who were considered “high risk.”
“No one really knows what happens when you move children with disabilities into an ACO model. Our case study provides some early insights that policymakers and health care administrators and providers can use as they attempt to improve the coordination of care and health outcomes of this population,” said Hilligoss.