CMS Health Care Innovation Award - Children's Hospital and Health System, Inc

Program Location: 
Milwaukee, WI
Payer Type: 

Children's Hospital and Health System (Children's Hospital of Wisconsin) has been awarded a $2.8 million grant from the Center for Medicare & Medicaid Innovation to pilot a program designed to reduce health care costs and improve quality of care. Children's is creating an Advanced Wrap Network Model (AWN) of culturally sensitive professional, clinical and social resources to educate members of Children's Community Health Plan (CCHP), 45,000-member Medicaid HMO serving southeastern Wisconsin, how to effectively navigate the health care system. CCHP is a member of Children's system.

The AWN will specifically target CCHP members who have had two visits to the emergency department within six months or those diagnosed with asthma who have had one visit to the emergency department or one admission to the hospital.

Over a three-year period of the grant, an estimated nine jobs will be created, including nurse and community health navigators. Mark Rakowski, executive director of CCHP, will serve as the grant administrator.

Nurse navigators will provide proactive outreach, guiding CCHP members and providers through the managed care system by providing one-on-one coordination of health care with the goal of promoting appropriate and timely access to services. The goal is for members to receive the right care, at the right time, in the right place.

Community health navigators will work within assigned geographic areas to facilitate care for CCHP members, coordinate social services and medical resources and serve as an additional point of contact for questions and to provide health education.

Last updated Aprile 2014
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