Health Care Coordination

Research has shown that children who have access to quality health care early in life:
* Benefit from recognition and earlier detection of health issues
* Are more likely to keep their appointments with doctors and specialists
* Have fewer ER visits
* Are hospitalized less than their peers
* Require less drug prescriptions than their peers (exception for chronic conditions)
* Have fewer unmet medical needs
* Benefit from more effective patient-provider interactions

Health Care Coordination Services include:

• At enrollment, a comprehensive plan of care is designed for each enrolled child.  This plan of care serves to both coordinate medical services and to maximize health outcomes. 

• If a child does not have a designated pediatrician at enrollment, his/her CHIP nurse, in cooperation with the family, will locate a primary care provider near the family’s home, arrange an initial visit for the child, follow up with the family to ensure that the appointment was kept, and issue reminders for upcoming well-child and immunization visits. 

• In addition to locating and establishing a medical home for each enrolled child, nurses improve the health status of children through medical case management, serving as liaisons between parents and physicians, dentists, and other health care providers. 

• CHIP requests medical records for each enrolled child on an ongoing basis; nurses review the records to check that the child is up-to-date on his/her well-child visits and immunizations, that he/she has attained the appropriate height and weight for his/her age, and that assessments have been conducted to check for speech and hearing delays. Nurses also review medical records for any recurring illnesses that might signal more serious health conditions and follow up with the child’s pediatrician if any concerns are noted.

Under nurse case management, families are empowered as they learn to self-manage the preventive health care of their children while breaking down the barriers that prevent them from seeking this care (transportation, myths about preventive care, prior negative health care experiences, etc.). Parents also receive anticipatory guidance for child growth and development as well as referrals and follow-up for primary care and special needs care to link children to comprehensive health services.