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 mission is to provide hope, care and cures to help every child live the healthiest and most fulfilling life possible. Together, Seattle Children’s Hospital, Research Institute and Foundation deliver superior patient care, identify new discoveries and treatments through pediatric research, and raise funds to create better futures for patients.

Ranked as one of the top children’s hospitals in the country by U.S. News & World Report, Seattle Children’s serves as the pediatric and adolescent academic medical center for Washington, Alaska, Montana and Idaho – the largest region of any children’s hospital in the country. As one of the nation’s top five pediatric research centers, Seattle Children’s Research Institute is internationally recognized for its work in neurosciences, immunology, cancer, infectious disease, injury prevention and much more. Seattle Children’s Hospital and Research Foundation works with the Seattle Children’s Guild Association, the largest all-volunteer fundraising network for any hospital in the country, to gather community support and raise funds for uncompensated care and research. Join Seattle Children’s bold initiative – It Starts With Yes: The Campaign for Seattle Children’s – to transform children’s health for generations to come.

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