This group pediatric practice provides family-centered care for children with special health care needs in a low-income, rural community. Patients and families benefit from a full time case manager that assists with coordinating care and following up with specialty providers.

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Implementation Insights:

  • Co-locate multidisciplinary services including mental and behavioral health with primary care.
  • Establish a 24 hour telephone service to enhance access to care.
  • Foster relationships with specialty care centers in the community to enhance care coordination.
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American Academy of Pediatrics