Children's and Its Physicians Join Forces With Insurers to Accelerate Transformation of Pediatric Care to a More Effective and Efficient Health Care Delivery System

Children's and Its Physicians Join Forces With Insurers to Accelerate
Transformation of Pediatric Care to a More Effective and Efficient Health Care
Delivery System

BOSTON, Nov. 4 /PRNewswire-USNewswire/ -- Children's Hospital Boston and its
physicians are creating a unique partnership with the state's major health
plans to accelerate the transformation of the pediatric care delivery system
by expanding innovative approaches and models of care. The approaches and
models currently being piloted at Children's are designed to improve health
outcomes and reduce costs by eliminating care that is not effective and over
utilized. The health plans - including Blue Cross Blue Shield of
Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan - have agreed
to an advisory role and to target funds toward the effort. The Massachusetts
Medicaid Program has also agreed to participate.

To work with insurers to develop a common approach and standards toward
improving care and reducing costs, Children's and its physicians have
volunteered a cut in fiscal year 2010 payment rates; in some cases reopening
contracts to cut rates of increase, and in others agreeing to reduce rates of
increase during current contract negotiations. Children's and the health plans
have agreed that a portion of these savings will be targeted to support these
promising and novel approaches and models. Investments will support SCAMPs (a
revolutionary way to provide clinicians with immediate feedback on the success
of their treatments), new models and systems for pediatricians to work with
specialists in coordinating care, and the most advanced pediatric information
technology underpinning these efforts.

"Over the past several years, we've made patient quality and safety our top
priority, invested in our clinical health information systems and tackled
hospital-wide operational improvement," said Sandra Fenwick, President and COO
at Children's.

"Those efforts have provided the confidence and platform on which to launch
this next generation of clinical effectiveness tools and models, which the
hospital and its physicians believe hold promise for transforming the health
care system nationally," added Paul Hickey, MD, president of the Physicians'
Organization at Children's.

A 10-member advisory panel, with equal representation from Children's and the
participating insurers, will provide valuable insight and strategic guidance
for these and future efforts. While insurers have broad experience with
clinical quality metrics and appropriateness of care guidelines, few of those
measures are specific to pediatrics. It is believed that bringing together the
broader experience of the insurers with the pediatric expertise of Children's
and its physicians will help to standardize the approach to high quality,
effective and efficient pediatric care.

New approaches, models and technologies for additional investment include:

SCAMPs (Standardized Clinical Assessment and Management Plans)
Although everyone's goal is to deliver the optimal tests, procedures and
treatments for each patient, as every physician knows, in most cases this has
never been defined. Physicians in the Cardiovascular Program at Children's
have created a broad-based framework to not only address this problem, but to
deliver better care at the same time. The framework, known as SCAMPs, or
Standardized Clinical Assessment and Management Plans, uses the best evidence
to guide testing and treatment decisions, and the best judgment of practicing
cardiologists to standardize care plans for many common clinical situations
and to capture data to continually refine the process.

"Children's and its doctors believe that the new framework will become the
standard for quality improvement processes - how to create in real time
widespread, continuous, data-driven quality improvement, including appropriate
utilization and potential cost savings, and will quickly spread to other
pediatric and adult care delivery," says James Lock, MD, chief of Cardiology
and one of the architects of the pioneering approach.

Integrated Care Models
Currently, efforts to improve collaboration between pediatricians and
pediatric subspecialists are underway. This is a crucial element of the
primary care model known as the family-centered Medical Home, in which a
primary care provider typically works in partnership with families to
coordinate care for their children. The fund will expand and accelerate
implementation pilots to improve access, communication, and optimal
utilization of resources across an integrated system which includes primary
care physicians, specialists and hospital, with a particular focus on
coordinating care for children and youth with complex and chronic conditions.

Next Generation Information Technology
Advanced information systems are essential to the health care delivery system
and are a critical component of Children's strategy moving forward. In
addition to the complicated systems needed for SCAMPs, the hospital has
developed the first patient-controlled health record fed by two separate
health care providers (pediatricians and specialists) giving patients a more
complete and comprehensive view of their medical information.

"The complexity and uniqueness of pediatric care compared to adult care
requires an extra level of effort to measure and improve quality," said Kathy
Jenkins, MD, chief quality and safety officer at Children's. "By creating a
common platform for discussion in Massachusetts with all major payers, we
should make significant progress in improving quality and effectiveness of
care while contributing to the state's position as a health care 'learning
laboratory' for the rest of the nation."

Children's Hospital Boston is home to the world's largest research enterprise
based at a pediatric medical center, where its discoveries have benefited both
children and adults since 1869. More than 500 scientists, including eight
members of the National Academy of Sciences, 11 members of the Institute of
Medicine and 13 members of the Howard Hughes Medical Institute comprise
Children's research community. Founded as a 20-bed hospital for children,
Children's Hospital Boston today is a 396-bed comprehensive center for
pediatric and adolescent health care grounded in the values of excellence in
patient care and sensitivity to the complex needs and diversity of children
and families. Children's also is the primary pediatric teaching affiliate of
Harvard Medical School. For more information about the hospital and its
research visit: www.childrenshospital.org/newsroom.

CONTACT:
Rob Graham
Children's Hospital Boston
617-919-3110
rob.graham@childrens.harvard.edu

SOURCE Children's Hospital Boston

Rob Graham, Children's Hospital Boston, +1-617-919-3110,
rob.graham@childrens.harvard.edu