The Indiana Complex Care Coordination Collaborative (IC4) delivers a coaching program for primary care embedded nurse care coordinators. It was piloted within the 10 state HRSA-funded Collaborative Improvement and Innovation Network (CoIIN) to Advance Care for Children with Medical Complexity between 2019-2022 in three pediatric practices. The three-fold goals of the project were:
- To improve the quality of life for children with medically complex conditions
- To improve the well-being of their families
- To increase the cost effectiveness of their care
The three Indiana pediatric primary care practices represented families living in rural, semi-rural and urban settings and included:
- Witham Pediatrics in Lebanon/Zionsville/Crawfordsville
- ALL IN Pediatrics in New Albany/Salem
- IUH Riley Pediatric Care Center in Indianapolis.
Each practice hired a nurse care coordinator who focused their full-time attention on serving the needs of 100 children with complex needs and their families. Family satisfaction surveys were utilized to measure quality of life and well-being. Preliminary Indiana Medicaid analysis is in progress to compare planned, scheduled versus unscheduled, and urgent health care utilization.
As a result of the program’s successful responses from families and primary care teams, Indiana Medicaid has now contracted with Indiana University School of Medicine to expand the model into 24 practices across the state, including practices which serve children with medical complexity and those who serve adults with intellectual disability receiving Bureau of Developmental Disabilities waivers. It is the aim of the expansion to demonstrate both the scalability and sustainability of the model for future application as a billable Medicaid model for complex care coordination.
