, Boston Medical Center, and Baystate Health Improve Care Coordination for Children with Medical Complexity

Share Article’s Care Coordination Record™ is being used by complex care teams in pediatrics to engage families, improve child and family quality of life and reduce healthcare costs, a national provider of team-based care coordination technology and services, today shared the preliminary results of its partners Boston Medical Center and Baystate Health demonstrating improved quality of life, family engagement, and reduction in cost with their “Collaborative Consultative Care Coordination Program” (4C). This multiyear collaboration serving medically complex children provides comprehensive care planning for patients and stronger care coordination across care teams via’s Care Coordination Record.


About one in 25 children born in the United States experiences medical complexity. The population of these children is increasing at a rate of about 5 percent annually, outpacing the growth rate of children as a whole, in part due to more babies surviving challenges such as premature birth and low birth weight, and improved treatment for conditions such as cystic fibrosis, congenital heart disease, and neurological conditions. Nationally, these children account for roughly 30% of pediatric health costs – $100 billion annually – comprising 55% of all pediatric inpatient and 85% of all pediatric 30-day readmission costs.

“The demands of caring for these children places a huge burden on families and their health providers, as well as the healthcare system as a whole,” said Matthew Sadof, MD, Co-Principal Investigator and complex care pediatrician at Baystate Health. “These children get care that spans multiple settings, health systems and siloed information systems. Our program bridges the space between complex layers of services that are required to care for these children and families.”


The multiyear collaboration, funded by the Center for Medicare and Medicaid Innovation, is called the Massachusetts Alliance for Complex Care (MACC). MACC is a partnership between Boston Medical Center, the largest safety-net hospital in New England, and Baystate Health, a healthcare system serving more than 750,000 people throughout western New England. The MACC care model improves child and family health and quality of life while reducing costs in many ways:

  • Multidisciplinary care teams: Families receive team-based care from a complex care pediatrician, child psychiatrist, developmental/behavioral pediatric specialist, clinical social worker, nutritionist, nurse care coordinator and family navigator. connects all care team members and drives action through the cloud-based Care Coordination Record.
  • Comprehensive care plans: Families and care teams work together to develop an individualized care plan, incorporating social and lifestyle needs, family priorities, and family-friendly language. Care plans in are secure and accessible to families and care teams at all times and can be shared with emergency departments and other treating health professionals as needed.

“The number of children with complex, long-term medical needs is growing, and many of these children require care and attention 24-7,” said Jack Maypole, MD, Co-Principal Investigator and complex care pediatrician at Boston Medical Center. “This team-based approach with help from’s tools leads to improved care, more time at home and in school, less time in the ER or hospital, less family stress, and overall savings in health care costs.”


  • Family engagement: Parents and caregivers for children with special healthcare needs experience significant challenges related to managing their child’s health and quality of life. Care teams often struggle to engage families in continuous care. Families use to communicate with the care team, assign and complete tasks, schedule appointments, and update the care plan. More than 100 families are using
  • Quality of life: Functioning scores across several domains measuring quality of life for children and families are increasing. Domains include: physical, emotional, social, school, and psychosocial.
  • Reduced healthcare costs: Early indications show significant cost savings. The program target is 20% and preliminary aggregate claims data for a small subset of patients show greater than 20% cost savings over the course of one year.

“Children with special health care needs and their families too often face a fragmented healthcare system that provides inconsistent or inadequate care,” said Ted Quinn, CEO. “Thankfully, MACC is changing the way the country delivers complex pediatric care. We believe that the MACC team and care teams everywhere deserve the best care coordination technology on the market, so we built it for them and we’re honored to be a part of this great work.”

The 4C Project is funded by a CMS Health Care Innovation Award (grant number 1C1CMS331326) shared by Boston Medical Center and Baystate Children’s Hospital.

About this Project
The project described was supported by Grant Number 1C1CMS331326 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. The research presented here was conducted by the awardee. Findings might or might not be consistent with or confirmed by the independent evaluation contractor.

About Boston Medical Center
Boston Medical Center is a private, not-for-profit, 496-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $119 million in sponsored research funding in fiscal year 2015. It is the 11th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. It does business in Massachusetts as BMC HealthNet Plan and as Well Sense Health Plan in New Hampshire, serving more than 315,000 people, collectively. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet – 13 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit

About Baystate Health
Baystate Health is a not-for-profit, mission-driven, integrated health system serving a population of over 750,000 people in communities across western Massachusetts. With roots dating to the founding of Springfield City Hospital in 1873, Baystate Health has been providing skilled and compassionate health care in the Pioneer Valley for more than 140 years.

About is a digital health company that simplifies complex care for everyone involved.’s Care Coordination Record™ connects all care team members and drives coordinated action through one cloud-based interoperable platform.’s Care Traffic Control™ extends the impact of care teams while supporting patients and preventing system failures. Learn more at

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