CoIIN to Advance Care for CMC

The Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity

The HRSA Maternal and Child Health Bureau has funded this collaborative improvement and innovation network (CoIIN) to test and spread promising care delivery strategies and payment models for children with medical complexity (CMC). The three-fold goals of the project are to:

  • Improve the quality of life for children with medically complex conditions
  • Improve the well-being of their families
  • Increase the cost-effectiveness of their care

Our staff leads a multidisciplinary collaborative consisting of federal, state, and local leaders working together to tackle the problem of improving care delivery and payment models for CMC and their families. Ten interdisciplinary state teams, composed of Title V Maternal and Child Health Program and Medicaid leaders, families raising CMC, providers, and other stakeholders have been identified and organized. These state teams, representing AL, CO, IN, KY, MA, MN, OR, TX , WA and WI, work within the CoIIN to develop, implement, and test new and innovative care delivery strategies and payment models for CMC. They receive guidance from our staff and a National Advisory Committee of experts in an array of relevant fields. Technical assistance, training and coaching is provided by nationally respected collaborative partners, including:

  • American Academy of Pediatrics
  • Population Health Improvement Partners
  • Health Management Associates
  • Association of Maternal and Child Health Programs
  • Family Voices

State teams continuously share data to learn from each other’s quality improvement efforts. Our staff, together with staff from the BU Department of Economics and the BU School of Public Health, will conduct a rigorous program of evaluation to monitor activities and make adjustments as necessary to improve efficiency and success of the state teams. Success in realizing project goals will be measured by the achievement over four years of the following objectives for each state team’s cohort of 150-300 CMC:

  • Increase the number of CMC reporting a single point of care in a medical home
    the number of CMC with a shared plan of care
    the number of families of CMC reporting previously unmet needs being met
  • Decrease the number of unscheduled/avoidable hospitalizations for CMC
  • One quarter of the state teams will have piloted an innovative payment model

This project is supported by HRSA of the U.S. Department of Health and Human Services (HHS) under grant number UJ6MC31113-01-00, Health Care Delivery System Innovations for Children with Medical Complexity, $2,700,000 (annually). This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Project Impact

At the end of four years, state teams will have improved outcomes for children with medically complex conditions, identified replicable care delivery and payment reforms, and developed methods to disseminate and spread them. Tools and resources will be available to share the learnings from the work of the CoIIN so other providers and state programs can use them to inform their own efforts to improve care delivery and payment reform for CMC.


Project Team Members