For this project, the Association for Community Affiliated Plans contracted with NORC to identify innovative models used by safety net health plans to provide care coordination and high-quality services to children with special health care needs. Through this effort, the NORC team also qualitatively characterized health plans' efforts to improve outcomes, access to health care services, and access to other needed supports for this special population served by state Medicaid programs.
NORC conducted semi-structured interviews with staff from twelve safety net health plans operating in nine states. Plans were selected to represent a diverse subset of safety net health plans with innovative programs serving children with special health care needs (CSHCN). Interviewees included plan leadership, care coordination staff, and staff specific to pediatric programs or targeted programs serving the CSHCN population.
The health plans interviewed use an array of approaches and data sources to identify and support children's health and other care needs, and rely on collaborative relationships with their providers and rigorous care coordination staffing to facilitate communication and collaboration. All plans emphasized the importance of relationship-building and rapport with families in identifying and addressing social determinants of health, and reported innovative uses of data to track care coordination, measure quality of care, and support novel payment approaches and incentive programs.
NORC prepared a report titled “Innovative Approaches in Care Coordination and Care Delivery for Children with Special Health Care Needs among Safety Net Health Plans,” which is available at https://www.communityplans.net/research/specialneedscarereport/.