This page includes a collection of tools and resources for all individuals, including pediatric clinicians, state agencies (Medicaid, Title V), family advocates, family/professional partnership groups, and other pediatric medical home stakeholders interested in care coordination.

Information about the National Center for Care Coordination Technical Assistance (NCCCTA) can be found under the "Technical Assistance and Support" heading. The NCCCTA is housed in the Integrated Care Program at Boston Children’s Hospital and supported through a partnership with the National Center for Medical Home Implementation.
Updated: December 2017

 Policy and Definition

    • Policy
    • Definition
      • Pediatric care coordination is a patient-and family-centered, assessment-driven, team-based activity designed to meet the needs of children and youth while enhancing the care giving capabilities of families. Care coordination addresses interrelated medical, social, developmental, behavioral, educational and financial needs to achieve optimal health and wellness outcomes. (Definition adapted from: American Academy of Pediatrics Council on Children with Disabilities and Medical Home Implementation Project Advisory Committee. Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems. Pediatrics. 2014; 133(5): e1451- 1460).

 Framework for High Performing Care Coordination

Originally published in the Commonwealth Fund report titled, "Developing Care Coordination as a Critical Component of a High Performance Pediatric Health Care System: Forging a Multidisciplinary Framework for Pediatric Care Coordination," this table is a guiding framework for care coordination competencies and functions.

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Reproduced with permission from Antonelli R, McAllister J, Popp J. Developing Care Coordination as a Critical Component of a High Performance Pediatric Health Care System: Forging a Multidisciplinary Framework for Pediatric Care Coordination. Washington, DC: The Commonwealth Fund; 2009.  

 Care Coordination Education/Capacity Building (Curricula)

 Measurement

              • Care Coordination Measurement Tool
                This tool enables assessment of value in health delivery models by measuring the activities of care coordination, necessary resources to implement those activities, and resulting outcomes.
*Note: Many of these measures are linked to specific conditions. While this measures set is important, the National Center for Care Coordination Technical Assistance supports implementation and measurement of care coordination across all settings and conditions. 

 Additional Tools and Resources

 Technical Assistance and Support

      • National Center for Care Coordination Technical Assistance
        The National Center for Care Coordination Technical Assistance (NCCCTA) is a partnership between the National Center for Medical Home Implementation and Boston Children's Hospital Integrated Care Program. The mission of the NCCCTA is to support the promotion, implementation and evaluation of care coordination activities and measures in child health across the United States.
          • The following technical assistance and support is available to individuals interested in implementing care coordination:
              • One hour of introductory technical assistance regarding the Pediatric Care Coordination Curriculum, Care Coordination Measurement Tool and the Pediatric Integrated Care Survey.
              • Two additional hours of technical assistance in the adaptation, implementation and evaluation of the aforementioned tools.
              • Assistance and support through email, as necessary.
      • Contact us for technical assistance and support.
      • View a graphical summary of a 2015 environmental scan, performed by the NCCCTA, that looked at care coordination activities across the United States. If you would like to receive a more comprehensive report, contact Hannah Rosenberg.
      • View a comprehensive poster describing the National Center for Care Coordination Technical Assistance.
      • To learn more about these care coordination tools, visit the Boston Children's Hospital Coordinated Care Web site.
      • To join the NCCCTA Community of Learners Listserv ®, email Neha Safaya. This listserv® is intended for anyone who is focused on pediatric care coordination capacity building and measurement. Valuable tools, measures, resources and publications are shared. Members are encouraged to pose questions for discussion and information about work that they are conducting.

 Practical Application of Care Coordination

  • Overview
      • The "Practical Application of Care Coordination" initiative is a collection of real life examples of care coordination implementation. The initaitive aligns with the mission of the National Center for Care Coordination Technical Assistance (NCCCTA) to create a community that is focused on care coordination capacity buildling and measurement.
      • In 2017, the NCCCTA merged its "Care Coordination in the Community" initiative with the National Center for Medical Home Implementation "Promising Practices" initiative. Examples of identified projects are included below.
  • If you are interested in having your project or initiative published on this Web page (the project or initiative does not need to be fully implemented in order to be published on this Web page) please email Hannah Rosenberg