We’ve all read about the quest to cover Medicare populations in accountable care, but as of late, I’ve been seeing more news items about kids being the focus of ACO-type models.
Several efforts are under way in the private sector and at the state level to apply this concept to pediatric care. The Children’s Mercy Hospital (CMH) in Kansas City, Mo., recently sold its Medicaid HMO to fund a new payment and care delivery model called an Integrated Pediatric Network (IPN) that will assume global capitation risk for children in the Kansas City area.
The IPN, which CMH views as a model of integrated care as opposed to an “ACO,” will be funded by the sale of assets of CHF’s Medicaid health plan, Children’s Mercy Family Health Partners (FHP), to Coventry Health Care, Inc. and will initially cover 110,000 Medicaid-covered children in the greater Kansas City metropolitan area. This includes pediatric lives with Coventry’s Medicaid MCO in Missouri.
Ohio, in the meantime, has shown an interest in providing accountable care for children. A budget document from Gov. John Kasich’s (R) Office of Health Transformation mentions plans to develop a pediatric ACO program that would focus on the needs of disabled children in the Medicaid program. Where pediatric ACOs appear to be stalling is at the federal level. Although the Affordable Care Act had authorized a pediatric ACO demo in the Medicaid program, there don’t appear to be any funds for it at the moment.
What have you heard about the ACA demo project? Do you think pediatrics is an area that other ACO-type models will specifically pursue and not just in the Medicaid arena?
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