This viewpoint in JAMA argues for regionalizing care and instituting accompanying payment reform to improve quality and reduce the costs of caring for children with complex healthcare needs.
“A recent report in the national media raised an important question: Who is monitoring and safeguarding the care of children with complex healthcare needs? The article reported on a hospital alleged to have a mortality rate for children undergoing heart surgery more than 3 times higher than the national average, prompting an investigation by the Joint Commission and the Centers for Medicare & Medicaid Services. In August of 2015, the hospital voluntarily closed its congenital heart surgery program. Although many details remain unclear, this investigation has stimulated a long overdue discussion regarding the optimal care of these and other children requiring complex, resource-intensive care.”