The ACC recently expressed supported of the Advancing Care for Exceptional Kids Act of 2015 (S. 298 and H.R. 546), bipartisan legislation introduced to improve care for children with medical complexity on Medicaid while helping contain costs. This legislation will improve Medicaid for two million of the nation's sickest children, approximately 6 percent of the children on Medicaid.

Only federal legislation can fix the national challenge of a fragmented system of care for children with medical complexity. These children may see six or more specialists and a dozen or more physicians, and often require care that takes them across state lines. Under the current Medicaid system—a system that is different in every state—the families of these children struggle to coordinate the complex, multi-state care of their kids.

The legislation will allow health care providers to form coordinated care networks to relieve families of the burdens associated with state-by-state Medicaid barriers to their child’s care. Nationally designated  networks will coordinate care and employ national quality standards, both essential to improving quality and  saving money. These networks will include a full range of providers, with children’s hospitals as anchors, to ensure children are able to visit the right provider at the right time, regardless of their location.

The legislation can deliver savings to Medicaid through increased efficiencies, including reducing hospitalizations and emergency room visits, while providing the array of outpatient and community services and supports needed by these children. Savings are estimated at $13 billion over 10 years.

Keywords: Child, Child Care, Cost of Illness, Hospitals, Pediatric, Specialization, Medicaid

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