University Hospitals Cleveland Medical Center – Rainbow Care Connection

Cleveland, OH
January 2018

Overview
Rainbow Care Connection (RCC) began as a multi-sector, public-private collaboration between UH Rainbow Babies & Children’s Hospital, employed and independent pediatric providers (including a large federally qualified health center), Ohio Medicaid managed care plans, Ohio Medicaid, local behavioral health organizations and community-based organizations. RCC, which is now a part of the UH Quality Care Network, brings together the above entities to assist all children, but particularly children with complex medical conditions and significant behavioral health needs (both drivers of high-cost care), with collaborating teams of doctors, social workers and resources right in their communities. A primary focus is neighborhoods where poverty is high, health literacy is low and disparities in health are great.

The Hough neighborhood in Cleveland and the suburb of Lyndhurst are separated by eight miles, yet the life-expectancy gap is 24 years. RCC helps to bridge that gap with comprehensive, high-intensity, team-based care.

UH Rainbow Babies & Children’s Hospital received a $12.7 million federal grant in 2012 to support the creation of the Rainbow Care Connection. UH subsequently invested heavily beyond that. We have trained health care workers to meet the special physical, emotional and cultural needs of our families most in need. Some patients and their families also get intensive training. Experts teach them how to manage and cope with symptoms, and use therapies and resources to control illness and its stresses.

And it works. Our providers receive thanks and emotional testimonials. One couple told us that before they encountered RCC, trying to care for their sick young daughter had driven them to the brink of emotional breakdown. They were losing all hope. Then they encountered RCC, and later wrote this note:

“Our daughter had a great day today... It has been a long time since I saw her be what used to be her normal happy self. Things are looking up, and I am so appreciative toward all of you. I can’t even begin to explain how hard it was before ... from the paperwork to the meds and everything in between. You all are the answer to a prayer we have been praying for such a long time. I really never imagined that our quality of life could improve so much in such a short period of time after having been so hard for so long. We are feeling renewed hope and we really needed that. Thank you all so much.”

Impact
The data support the anecdotes: Since the model’s inception, data from UH Rainbow demonstrates a significant decrease in hospitalizations for children with behavioral health conditions (57 percent) and medically complex children (25 percent). The study also recorded a decrease in unnecessary visits to the emergency department (22 percent) for all children. In 2016, an independent two-year financial impact case study demonstrated a 5.6 percent cost-of-care savings for RCC’s Medicaid patients.

Lessons Learned
Instead of focusing on responding to crisis episodes when symptoms spiral out of control, RCC aims to manage diseases in the community. Instead of dealing with crisis, it helps families become healthier, so children don’t need a hospital or ED.

Future Goals
Outcomes are improving. And so are costs. This is a view of the future of health care.

Contact: Heidi Gartland
Vice President, Government and Community Relations
Telephone: 216-844-3985
Email: heidi.gartland@uhhospitals.org