Cook Childrens Health Plan

KNOWING THAT EVERY CHILD'S LIFE IS SACRED OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY

COOK CHILDREN'S HEALTH PLAN PROVIDES HEALTH CARE COVERAGE TO A VULNERABLE POPULATION THAT MAY NOT OTHERWISE BE ABLE TO ACCESS OR AFFORD CARE-LOW-INCOME FAMILIES WHO QUALIFY FOR GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICAID AND THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). CHILDREN ENROLLED IN CCHP ARE ASSURED TIMELY ACCESS TO NECESSARY MEDICAL CARE, INCLUDING PREVENTIVE SERVICES SUCH AS WELL-CHILD VISITS, IMMUNIZATIONS AND PRENATAL/POSTPARTUM CARE. COOK CHILDREN'S HEALTH PLAN'S ROLE IS TO MANAGE AND, IN CONJUNCTION WITH COOK CHILDREN'S AND OTHER NETWORK PROVIDERS, DELIVER CARE TO ITS MEMBERS. SINCE IT WAS ESTABLISHED IN 1999, THE ORGANIZATION HAS SUCCESSFULLY GROWN TO A SUBSTANTIAL OPERATION, CURRENTLY COVERING MORE THAN 160,000 MEMBERS, PRIMARILY REPRESENTING CHILDREN AND EXPECTANT MOTHERS. IN ADDITION TO THE NEARLY 770 PHYSICIANS IN THE COOK CHILDREN'S PHYSICIAN NETWORK, MEMBERS HAVE ACCESS TO APPROXIMATELY 1,100 ADDITIONAL PRIMARY CARE PHYSICIANS, 240 OB-GYNS, 1,820 SPECIALISTS, 510 BEHAVIORAL HEALTH PROVIDERS, AND NUMEROUS HOSPITALS, SURGERY CENTERS AND A VARIETY OF URGENT CARE AND CLINIC LOCATIONS. THIS COMPREHENSIVE NETWORK ENSURES ACCESS TO QUALITY HEALTH CARE PROVIDERS FOR ALL CCHP MEMBERS. MEMBERS WITH CHRONIC CONDITIONS SUCH AS ASTHMA AND DIABETES CAN PARTICIPATE IN THE PLAN'S VIGOROUS AND EFFECTIVE DISEASE MANAGEMENT PROGRAMS, WHICH HELP PREVENT UNNECESSARY AND COSTLY EMERGENCY DEPARTMENT VISITS AND HOSPITALIZATIONS, AS WELL AS HELP PREVENT FURTHER DETERIORATION OF THEIR HEALTH. ALTHOUGH COOK CHILDREN'S MEDICAL CENTER DOES NOT DELIVER BABIES, PREGNANT MEMBERS ARE CLOSELY CARED FOR AND MONITORED TO AVOID COMPLICATIONS AND PREMATURE DELIVERIES. COOK CHILDREN'S MEDICAL CENTER IS OFTEN THE HOSPITAL OF CHOICE FOR MEMBERS' NEWBORNS WHO REQUIRE NEONATAL INTENSIVE CARE. EFFECTIVE ENGAGEMENT WITH THE COMMUNITIES WE SERVE IS ONE OF CCHP'S STRENGTHS. PRIOR TO THE PANDEMIC, FULL-TIME OUTREACH STAFF WOULD VISIT FAMILIES, SCHOOL NURSES, CHURCHES AND OTHER FAITH AND/OR CULTURAL ORGANIZATIONS TO SHARE INFORMATION ABOUT CCHP AND THE MEDICAID AND CHILDREN'S HEALTH INSURANCE PROGRAMS. THE PANDEMIC REQUIRED CCHP TO GET CREATIVE IN HOW STAFF SEEK OUT THOSE WHO NEED HELP FINDING THE RIGHT SERVICES AND ASSIST THOSE WHO QUALIFY TO APPLY FOR THE GOVERNMENT-FUNDED HEALTH INSURANCE PROGRAMS. LIKE MOST ORGANIZATIONS, CCHP WENT VIRTUAL IN ALL OF THE WAYS IT COULD TO CONTINUE TO SERVE ITS MEMBERS. OF CCHP'S 345 EMPLOYEES, 90% TRANSITIONED TO HYBRID OR FULL-TIME WORK FROM HOME. VIRTUAL MEETINGS TOOK THE PLACE OF HOME VISITS FOR MEMBER ASSESSMENTS CONDUCTED BY CARE MANAGEMENT STAFF, AND VIRTUAL MEETING PLATFORMS WERE UTILIZED TO KEEP EMPLOYEES CONNECTED. THIS ALLOWED CCHP TO HOLD BOARD OF TRUSTEES MEETINGS, MONTHLY LEADERSHIP MEETINGS, AND STAFF TOWN HALL MEETINGS WITHOUT INTERRUPTION DURING THE PANDEMIC. THE PANDEMIC DID NOT HAMPER CCHP'S EFFORTS TO IMPROVE ITS OPERATIONS TO ENSURE ITS MEMBERS RECEIVE TOP-QUALITY SERVICE IN AN EFFICIENT MANNER. AFTER A TWO-YEAR BUILD PROCESS IN COLLABORATION WITH COOK CHILDREN'S HEALTH CARE SYSTEM'S INFORMATION SERVICES TEAM, CCHP IMPLEMENTED THE EPIC TAPESTRY MANAGED CARE PLATFORM IN SEPTEMBER 2020, AND RECEIVED NCQA HEALTH PLAN ACCREDITATION IN AUGUST 2021. THIS IS THE INDUSTRY'S GOLD STANDARD PROGRAM FOR QUALITY IMPROVEMENT AND MEASUREMENT.