Covering Children with Serious Chronic Health Conditions

Throughout the last decade, children with serious chronic conditions requiring substantial and costly healthcare intervention — typically referred to in legislation as “medically complex” —  have increasingly sought care at children’s hospitals throughout the nation, including Children's Hospital of Philadelphia (CHOP). These children include an estimated 6.5 percent of Medicaid-enrolled children, yet account for around 40 percent of Medicaid spending on children’s healthcare. 

In an effort to improve care coordination and reduce costs for children with medical complexities on Medicaid, U.S. Senators Chuck Grassley (R-Iowa) and Michael Bennet (D-Colorado) introduced bipartisan legislation called the Advancing Care for Exceptional (ACE) Kids Act (S. 428) in February 2017.  The proposed legislation, supported by CHOP, is voluntary for states and aims to improve care coordination by working within the existing structure of a state’s Medicaid program.

For more information or to learn how to be an advocate for the ACE Kids Act, please visit the Children’s Hospital Association website.

CHOP Compass Care Program

Since children with medical complexities have become a larger proportion of CHOP’s patient population, CHOP has implemented a population- and value-based initiative called Compass Care to coordinate and manage care for these high-risk children. For each enrolled patient, the model includes a Hospital-based, multidisciplinary team that provides services in close collaboration with insurers, the patient’s primary care provider, specialists, and the patient’s family.

Learn more about CHOP's Compass Care Program.