Friday, April 01, 2022
The National Care Coordination Academy (NCCA) is a collaboration between the Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity (CMC CoIIN) and Boston Children’s Hospital. This two-year program has assisted state teams in building sustainability for their care coordination models for CMC. In this interview, Richard Antonelli, MD and Heather Pomella, NP, Medical Director and Manager of the NCCA respectively, discuss how the CCA came to be and the impact it has had for participants. This conversation has been edited for length and clarity by Candace Jarzombek, CMC CoIIN Graduate Research Fellow.
What motivated the creation of the CCA?
Dr. Richard Antonelli: When Meg Comeau, Principal Investigator for the CMC CoIIN, first approached me, more than two years ago, the CoIIN had a couple of webinars on care coordination, and feedback from the teams came back and they wanted more. That’s what really set the platform ablaze, as far as I’m concerned. We just needed four [CMC CoIIN] state team participants, and year one, it grew to what, a dozen [including external teams]? Then year two, we had two new teams join. I think that that demonstrates an ongoing appetite across the country for ongoing technical assistance for care coordination capacity building, interprofessional training, and performance measurement. I want to make sure that we give Meg a strong shout out here because it was her offer to make the NCCA happen. I’m just so grateful for her leadership.
What have been the most impactful elements of the CCA, both for you as leaders and for the state teams?
Heather Pomella: I feel like we gave a platform for teams to practice talking about the work that they do, and how to articulate the importance of what they’re doing to advocate for more funding, or even just to advocate for more respect within their own communities and their own clinics. One of our main faculty members is Jeff Schiff, who is a physician and past Medicaid medical director. To have him on all of these meetings and hearing about all these teams’ projects and to get his live feedback, I think was really special.
Dr. Richard Antonelli: Just like politics, care coordination is all local, but one of the powerful elements of the Academy is to call out what are the common themes, tools, and elements, that are the things every state Title V director, every Medicaid director, every family leader should be thinking about every day in this space. I think what the leadership of the NCCA has really done is to coalesce around those common elements, but then allowing each state team to leverage its own strengths and bridge their respective gaps.
Did the CCA help reduce the social isolation within the pandemic?
Dr. Richard Antonelli: I think that the isolation, especially for families of CMC, and adults with disabilities, if anything, was truly exacerbated during the pandemic. There is an element of the Academy that I think provided a community of support, and that was really crystallized around a shared sense of mission and a shared sense of vision. I think that’s one of the things that I found particularly compelling about the Academy.
What were each of your biggest takeaways from the CCA?
Heather Pomella: In terms of biggest takeaways, the work isn’t done, we are sort of just getting started. We accomplished a lot, but the work doesn’t stop here. I hope that teams are able to continue with what they’ve learned. Other big takeaways are the importance of family engagement throughout care coordination, [and] building out your program. You should always have a family partner helping you with this process so that it incorporates your population, and you’re getting that feedback. Get to know your population, [and] make sure you’re serving the needs of your population. What you might think is what they need is maybe not what’s most important to them, so just asking them, being open and honest, and just being there for them is important.
Dr. Richard Antonelli: The key takeaways are this: CMC, CYSHCN, and their families, need care coordination. It has measurable outcomes that meet the expectations of families. Can we do better? Absolutely. We must do better. There are disparities of access to care, disparities to access in care coordination capabilities and resource allocation, and these are rampant. One of the things that I feel is essential going forward is an explicit focus on race, ethnicity, language, and disability status in our training, in our performance measures, and in our advocacy for all things related to healthcare delivery in the United States.