Child Health Accountable Care Collaborative of NC (CHACC) is a partnership with Community Care of North Carolina (CCNC) to develop a model for coordinated care that will improve the health, quality of care, and costs for hospitalized Medicaid-sponsored children with medical complexity (CMC). This is accomplished through the implementation of a combined program of outpatient and inpatient-based care management services.
- To implement high quality transitions of care services for hospitalized children by embedding care management specialists in the Duke Children’s inpatient setting
- To enhance co-management between subspecialist and primary care providers (PCP) in the patient’s medical home through the implementation of outpatient care management specialists linked with Duke Children’s subspecialty clinics to help serve discharged CMC
- To improve capacity of the existing CCNC outpatient Pediatric care management model by increasing services for the most medically complex hospitalized children
CHACC has six total full-time positions
A. Inpatient Team
The inpatient CHACC team consists of two full-time positions, a care manager with RN-level training who serves as team lead and one patient coordinator who serves alongside the care manager to directly provide inpatient transitional care services.
B. Outpatient Team
The outpatient team consist of four full-time positions positions. One RN-trained care manager and one Master’s level Social Worker and two patient coordinators (one bachelor’s-trained and one community health worker with community experience) who work collaboratively to provide longitudinal care management to enrolled CHACC patients.