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As health care and financing systems become more sophisticated, health care systems are increasingly using a process known as “risk tiering” to group patients with similar degrees of need for health care and care coordination services. Payers are becoming part of this conversation, which for children is in its very early stages. Families and care providers of children with chronic and complex conditions should understand the risk tiering process, as it may affect access to services these children need. 

This conversation was led by the authors of Aligning Services with Needs: Characterizing the Pyramid of Complexity Tiering for Children with Chronic and Complex Conditions

Webinar Recording


Christopher Stille, MD, MPH

Christopher Stille, MD, MPH, is professor of pediatrics and section head of General Academic Pediatrics at the University of Colorado School of Medicine and Children's Hospital Colorado. The primary focus of his research has been improving communication and coordinated care for CYSHCN between primary care clinicians, subspecialists, and family members. He has led projects funded by the U.S. Maternal and Child Health Bureau, the Robert Wood Johnson Foundation, and local and regional funders to pursue this investigation. 

Nora Wells, MSEd

Nora Wells, MSEd, is executive director of Family Voices, a national grassroots network of families and professionals dedicated to improving health care systems and services for children and youth with special needs. She has directed multiple family-led research and programmatic projects and initiatives, promoting the engagement of families in the design and delivery of quality family-centered health care services for children. She is the parent of an adult son with cerebral palsy.

James Perrin, MD

James Perrin, MD, is professor of pediatrics at Harvard Medical School and former director of the Division of General Pediatrics at MassGeneral Hospital (MGH) for Children, having previously headed a similar division at Vanderbilt. He holds the John C. Robinson Chair in Pediatrics at MGH. He was president (2014) of the American Academy of Pediatrics, chair of its Committee on Children with Disabilities, and past president of the Ambulatory (Academic) Pediatric Association. 

Holly Henry, PhD

Holly Henry, PhD, is research program manager at the Lucile Packard Foundation for Children's Health. Her work is focused on improving care coordination and self-management support for children with special health care needs and their families. She also directs the California Community Care Coordination Collaborative. She earned her PhD at the Johns Hopkins Bloomberg School of Public Health.

Related Grants

This fact sheet from the National Health Law Program is designed to inform families about the steps they can take to appeal decisions about their child’s CCS benefits and highlight key resources available to support the process.

The National Academy for State Health Policy convened a national forum  to discuss innovations, strategies, and opportunities to improve high-quality, equitable care coordination for children and youth with special health care needs, with particular focus on integrated care and the care coordination workforce.