LPFCH Care Coordination Project
Options for Financing Care Coordination for Children and Youth with Special Health Care Needs
In this project, funded by the Lucile Packard Foundation for Children’s Health, we gathered information from a literature review and stakeholder and state Title V staff interviews and identified options for financing and reimbursement of care coordination services for families of CYSHCN. Care coordination financing and reimbursement may be impeded by a range of barriers such as poorly structured payment mechanisms, low reimbursement rates, insufficient incentives to pay for care coordination, lack of clarity about who is responsible for providing and paying for care coordination, and overall limits on funding for services for CYSHCN, among others. We identify options for financing and reimbursement of care coordination services that overcome these barriers and promote payment for care coordination. We make recommendations for adopting these options, drawing on a robust array of stakeholder perspectives including clinicians, payers, policymakers, families, and others. With specific guidance about options for sustaining care coordination and broad dissemination of these findings, stakeholders are provided with the information they need to adopt proven care coordination strategies that will benefit the health and well-being of CYSHCN and their families, and improve the overall system of care.
We identified concrete strategies to fund care coordination, a service that is needed by about half of families of children and youth with special health needs but is not available due to financing and reimbursement barriers.