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Although children with medical complexity (CMC) represent <1% of the U.S. pediatric population, their medical care needs account for 33% of U.S. healthcare spending for children. Providing high-value care for these vulnerable children involves a multidisciplinary team approach aimed at improving outcomes with increased use of outpatient services and a reduced number of hospital days. This approach requires coordination of care. Nonreimbursed costs of coordinating care for CMC have not previously been determined.
The authors studied nonbilled care-coordination activities performed at a single institution for 208 CMC. Cost was estimated by assessing the time spent on these activities at the rate of pay for staff performing them. They captured …