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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Care Coordination.

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Strategy. Partnerships and Collaboration

Approach. Develop partnerships and collaboration to form a complex care program for children with medical complexity to better meet their care coordination needs.

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Overview. Implementing a consultative, or comprehensive, complex care program can lead to improved outcomes for children with medical complexity and their families.[1,2] Some improved outcomes include reduced spending, a decrease in emergency department usage, and relief expressed by the child's primary caregiver.[1,2]

Evidence. Moderate Evidence. Strategies based on moderate evidence show a clear trend toward positive results. While these approaches are likely to be effective, further research is needed to confirm their impact. Implement with evaluation to better understand specific local effects.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Cross-sector data sharing agreements and metrics
  • Partnership satisfaction surveys
  • Service duplication and efficiency audits

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of organizations participating in collaborative networks led by Title V to establish complex care programs for children with medical complexity. (Measures multi-sector engagement)
  • Number of children supported by Title V with medical complexity served by integrated complex care programs. (Assesses reach of collaborative programs)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of complex care partnerships led by Title V establishing formal governance structures and shared accountability metrics. (Assesses partnership infrastructure)
  • Percent of partners led by Title V consistently participating in collaborative care planning with families. (Measures engagement in collaborative care delivery)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of families reporting high levels of care coordination across their child's care team. (Measures family experience of integrated care)
  • Number of complex care teams meeting quality performance benchmarks. (Assesses care quality impact of partnerships)
  • Number of regions establishing high-performing complex care delivery systems through partnerships. (Measures spread of collaborative models)
  • Number of policies and system changes achieved through coordinated support of complex care partnerships. (Shows systems change impact)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of complex care partnerships driven by priorities of families voiced by families themselves. (Measures authentic community leadership)
  • Percent of partnerships adopting engagement and investment strategies who report high levels of collaboration among participants. (Assesses commitment to engagement)
  • Percent reduction in complex care differences experienced by children. (Measures health impact)
  • Percent of families reporting increased trust and capability in shaping complex care systems. (Assesses shifts in decision-making influence)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Hogan, A., Galligan, M. M., Stack, N. J., Leach, K. F., Aredas, B., English, R., Dye, M. W., & Rubin, D. M. (2020). A tertiary care-based complex care program. Medical Care, 58(11), 958–962. https://doi.org/10.1097/mlr.0000000000001388

[2] Bergman DA, Keller D, Kuo DZ, Lerner C, Mansour M, Stille C, Richardson T, Rodean J, Hudak M. Costs and Use for Children With Medical Complexity in a Care Management Program. Pediatrics. 2020 Apr;145(4):e20192401. doi: 10.1542/peds.2019-2401. PMID: 32229620.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author 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.