Children's Hospital Colorado Advances in National Health Care Innovation Grant Program, Will Share in $360 Million

Test model will work to improve care while reducing costs

Bennet Pushing to Increase Program’s Scope

 Colorado U.S. Senator Michael Bennet announced that the National Association of Children’s Hospitals, including Children’s Hospital Colorado, has advanced to round two of the Centers for Medicare and Medicaid Service’s Health Care Innovation Awards Program.  The program encourages medical service centers to apply for grants to test innovative new care models that reduce costs while improving the quality of care for people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

Health and Human Services Secretary Sylvia Mathews Burwell announced the awardees earlier last week, bringing the total amount of possible funding for 39 potential recipients spanning 27 states and the District of Columbia to $360 million. The awards are expected to be finalized later this summer.

“Innovative models like those being tested by Children’s Colorado are finding ways to produce better medical outcomes more cost effectively.  They help us improve the delivery of medical care overall for children and families and we are thrilled to have a hospital right here in Colorado chosen for this grant, ” Bennet said.  “Ultimately, these models can show us how to bring costs down nationwide.”

“This grant acknowledges that Children’s Hospitals can serve as the experts in driving innovative, even transformative changes in how we deliver  care for children with chronic and complex medical conditions,” said Jim Shmerling, CEO of Children’s Hospital Colorado. “This  recognition highlights the critical role played by children’s hospitals in the nation’s health care system.”

The National Association of Children’s Hospitals is receiving an award to test a program entitled Coordinating All Resources Effectively (CARE).  The program targets Children with Medical Complexity (CMC), which are children who have medically intensive needs that are not being easily met by current health care services. Almost 3 million of the nation’s 76 million children have medical complexity, and their care generates the highest expenses in the Medicaid program.

Children’s Colorado aims to improve care and reduce expenditures of CMC by:

  • Developing a medically appropriate tiered system of care to meet varying CMC needs,
  • Designing a payment system to sustain the program and provide families with flexibility, and
  • Creating a system that will allow programs and patients across the nation to share information.

The program will be tested in Colorado and five other states, although proponents, including Bennet are pushing to expand it nationwide.

Bennet introduced an amendment last December to implement these strategies on a national level to improve care and reduce Medicaid costs.  It would ease current barriers to care that exists when crossing state lines, create consistent data and medical standards to improve care nationwide for CMC, and allow all 50 states to unilaterally implement reforms.

The Health Care Innovation Awards Program is made possible through the Affordable Care Act.  Other potentially funded round 2 projects include programs to promote better care for HIV/AIDS patients, reduce unnecessary use of emergency departments, improve pediatric dental care, promote prevention and management of cardiovascular disorders, and improve care and coordination in rural areas of the country.