Cincinnati Children's Health Network

Case study on the Cincinnati Children’s Health Network

Carol Read RN/MSc

The network consists of Cincinnati Children’s medical center facilities and physicians, in partnership with community pediatricians, federally qualified health centers (FQHCs), city clinics and other community providers.Health Network by Cincinnati Children’s (HNCC) is a community-based network of providers in and outside of the Cincinnati Children’s.Our mission is to improve the system of healthcare for kids in our community. The network consists of Cincinnati Children’s medical center facilities and physicians, in partnership with community pediatricians, federally qualified health centers (FQHCs), city clinics and other community providers.

The Network partners with two managed care plans — Paramount Advantage and Molina Healthcare — and is responsible for the medical management of the Medicaid population in southwest Ohio from birth through 18 years of age, including some patients up to 21 years of age. Medical management includes: Prior Authorizations, Utilization Review, Specialist Referrals, and Case Management.

Under the guidance of medical director, Melodie Blacklidge, MD, associate medical director, Scott Callahan, MD, and executive community physician leader, Camille Graham, MD, the dedicated team of HNCC case managers, social workers, community health workers and a mental health facilitator are available to assist your patients. Our network consists of Cincinnati Children’s facilities and physicians, in partnership with community pediatricians, federally qualified health centers (FQHCs), city clinics and other community providers.

HNCC assumes responsibility for coordinating and managing the healthcare of the pediatric Medicaid population enrolled in Paramount Advantage and / or Molina Healthcare, and that resides in the following eight-county southwestern Ohio service area: Adams County, Brown County, Butler County, Clermont County, Clinton County, Hamilton County, Highland County, and Warren County.

More details can be found here on how the network is managed within the complex USA healthcare system.