Purpose Of Review: The aim of this study was to summarize emerging elements of paediatric alternative payment models (APMs), identify strategies to address barriers in implementing paediatric APMs and share policy approaches.
Recent Findings: The unique health needs of children and adolescents must be considered as paediatric value-based care and APMs are developed. The longer time period for achieving cost savings, relatively few existing model tests and challenges with cross-sector data-sharing and pooled financing are barriers to the adoption of paediatric APMs. The Integrated Care for Kids (InCK) model and some state-based efforts are testing whether an integrated service delivery model combined with paediatric APMs can reduce expenditures and improve care and outcomes. However, the relative paucity of models makes it difficult to identify the most effective strategies and overall impact of paediatric APMs.
Summary: Emerging paediatric APMs include the following key elements: developmentally appropriate approaches, paediatric-specific quality and cost measures, a focus on primary care, special considerations for children with complex healthcare needs and cross-sector integration of data, workforce and financing. A variety of strategies, rooted in cross-sector partnerships, can be pursued to address implementation barriers and ultimately support paediatric care transformation.
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http://dx.doi.org/10.1097/MOP.0000000000001090 | DOI Listing |
J Arthroplasty
February 2025
Center on Stress & Health, University of California Irvine, Orange, California; American College of Perioperative Medicine, Corona Del Mar, California; Department of Anesthesiology and Perioperative Care, University of California Irvine School of Medicine, Orange, California; Department of Pediatrics, CHOC Children's Hospital, Orange, California.
Background: Ambulatory surgery centers (ASCs) are increasingly replacing traditional hospital settings for orthopaedic procedures, driven by advancements in surgical techniques, anesthesia, and enhanced recovery protocols. These innovations enable complex procedures to be performed safely in outpatient settings. ASCs align with value-based care (VBC) principles by offering cost-effective, high-quality, and patient-centered care.
View Article and Find Full Text PDFCardiol Young
May 2024
Department of Pediatrics, Children's Healthcare of Atlanta Cardiology, Emory University, Atlanta, GA, USA.
Objective: Children with prolonged hospital admissions for CHD often develop delirium. Antipsychotic medications (APMs) have been used to treat delirium but are known to prolong the QTc duration. There is concern for prolongation of the QTc interval in cardiac patients who may be more vulnerable to electrocardiogram (ECG) changes and may have postoperative QTc prolongation already.
View Article and Find Full Text PDFPediatric value-based payment reform has been hindered by limited return on investment (ROI) for child-focused measures and the accrual of financial benefits to non-health care sectors. States participating in the federally-funded Integrated Care for Kids (InCK) models are required to design child-centered alternative payment models (APMs) for Medicaid-enrolled children. The North Carolina InCK pediatric APM launched in January 2023 and includes innovative measures focused on school readiness and social needs.
View Article and Find Full Text PDFValue Health
February 2024
Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven CT, USA.
The objective of this study was to examine dental providers' familiarity with and attitudes toward alternative payment models (APMs) in a value-based care (VBC) delivery model. The authors analyzed responses to questions pertaining to VBC and APMs from a survey conducted between March and April 2021. Responses were stratified by age, race, practice location, practice type, and provider specialty using descriptive and inferential analysis, including Pearson chi-square or Fisher exact test.
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