Seattle Children's Receives $5.56 Million Grant from Centers for Medicare & Medicaid Services to Pilot Coordinated Care Program

Program aimed at improving the lives of special needs patients while reducing costs

Seattle Children's announced today that it is the recipient of a $5.56 million grant from the Centers for Medicare & Medicaid Services to test the implementation of Pediatric Partners in Care (PPIC), a program aimed at improving health outcomes and reducing costs of care for disabled children with multiple medical issues.

The three-year pilot program, which begins this month, includes 3,000 Supplemental Security Income (SSI) patients on Medicaid in King and Snohomish counties.

"The PPIC program represents a huge leap forward for the special needs children we serve," said Dr. Sandy Melzer, senior vice president and chief strategy officer for Seattle Children's. "These children and their families already have so many challenges to face. It is our responsibility to look for ways to improve their lives while also taking a leadership role in supporting national goals to reduce costs of care."

The pilot program uses targeted care management strategies to ensure that patient care is coordinated and efficient. This includes utilization of tiered care management approaches, shared care plans, integrated behavioral health and primary care, clinical standard work for management of common problems, and coordination of specialist and primary care teams, including at school, Melzer said.

The grant is administered through the CMS Innovation Center, which was established to test innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care for those individuals who receive Medicare, Medicaid, or Children's Health Insurance Program (CHIP) benefits. Seattle Children's applied because of the hospital's unique expertise in providing care for special needs children as well as the hospital's commitment to improving care and results while minimizing costs.

"There is growing recognition of the challenges of improving outcomes and decreasing medical expenses for children with special needs," said Melzer. "Children's Hospital Association is supporting legislation to develop federally-designated centers for children with special health care needs on a regional basis." The work positions Seattle Children's to pilot innovative approaches to improve outcomes and reduce costs of care for children – an approach that could be implemented on a national level, he added.

Results from the pilot program will be evaluated by CMS and the Group Health Research Institute. Melzer expects they will be shared on a national level.

"For me, it is about doing the right thing for a challenging group of children and families," Melzer said. "If we can reduce costs at the same time, then all the better."

About Seattle Children’s

Seattle Children’s Hospital, Foundation and Research Institute together deliver superior patient care, advance new discoveries and treatments through pediatric research, and raise funds to create better futures for patients. Consistently ranked as one of the top 10 children’s hospitals in the country by U.S. News & World Report, Seattle Children’s Hospital specializes in meeting the unique physical, emotional and developmental needs of children from infancy through young adulthood. Through the collaboration of physicians in nearly 60 pediatric subspecialties, Seattle Children’s Hospital provides inpatient, outpatient, diagnostic, surgical, rehabilitative, behavioral, and emergency and outreach services to families from around the world.

Located in downtown Seattle’s biotech corridor, Seattle Children’s Research Institute is pushing the boundaries of medical research to find cures for pediatric diseases and improve outcomes for children all over the world. Internationally recognized investigators and staff at the research institute are advancing new discoveries in cancer, genetics, immunology, pathology, infectious disease, injury prevention, bioethics and much more.

Seattle Children’s Hospital and Research Foundation and Seattle Children’s Hospital Guild Association work together to gather community support and raise funds for uncompensated care, clinical care and research. The foundation receives nearly 80,000 gifts each year, from lemonade stand proceeds to corporate sponsorships. Seattle Children’s Hospital Guild Association is the largest all-volunteer fundraising network for any hospital in the country, serving as the umbrella organization for 450 groups of people who turn an activity they love into a fundraiser. Support from the foundation and guild association makes it possible for Seattle Children’s care and research teams to improve the health and well-being of all kids.

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