Designing Alternative Payment Models for Child Health and Development

Overview:

The current health care system is not structured to fully support child health and development. Rather, the system focuses on the delivery of services that are designed to manage specific diseases and chronic conditions and is often separate from an individual’s community and other sectors that impact child health and development (e.g., education, social services). This arrangement often leads to overlooking prenatal and early childhood factors, including adverse childhood events and stress, socioeconomic status, relationships with parents and caregivers, and access to early education, that can impact mental and physical health over the course of a lifetime. Alternative payment model (APM) structures and incentives can help redesign the health care system and bring organizations from different sectors together to deliver services that address the needs of children and their families and better support child health and development.

This collaboration between the Duke-Margolis Center for Health Policy, Mental Health America, and the UCLA Center for Healthier Children, Families, and Communities aimed to outline how the next generation of APMs can be designed to meet the developmental, medical, and social needs of children and their families and how financial, regulatory, and other barriers can be overcome. In November 2019, the collaboration hosted a two-day convening of subject matter experts to discuss a path forward. The results from this meeting as well as other research and conversations with leaders in children’s health, social determinants of health, and community health informed the issue brief below.

Read the issue brief here. 

Project Team:

Robert S. Saunders, PhD, Research Director, Payment and Delivery Reform, Duke-Margolis Center for Health Policy

Rachel Roiland, PhD, Research Associate, Payment and Delivery Reform, Duke-Margolis Center for Health Policy

Elizabeth Singletary, Research Assistant, Payment and Delivery Reform, Duke-Margolis Center for Health Policy

Susan Dentzer, Senior Policy Fellow, Duke-Margolis Center for Health Policy

Mark McClellan, MD, PhD, Director, Duke-Margolis Center for Health Policy, Professor of Business, Medicine and Health Policy

Nathaniel Counts, JD, Senior Vice President, Behavioral Health Innovation, Mental Health America

Nicole Pereira, Transformation Fellow, UCLA Center for Healthier Children, Families, and Communities 

Jared Schor, Program Manager, UCLA Center for Healthier Children, Families, and Communities 

Neal Halfon, MD, Director, UCLA Center for Healthier Children, Families, and Communities 

About the Duke Margolis Center for Health Policy:

The Robert J. Margolis, MD, Center for Health Policy at Duke University is both an academic research center and a policy laboratory. Its mission is to improve health and the value of health care through practical, innovative, and evidence-based policy solutions. To learn more, please visit healthpolicy.duke.edu.

About the UCLA Center for Healthier Children, Families & Communities:

The Center for Healthier Children, Families & Communities is a multidisciplinary, community-focused research, policy, and training center at UCLA. Established in 1996, we are joint effort of the David Geffen School of Medicine Department of Pediatrics and the UCLA Fielding School of Public Health.

About Mental Health America:

MHA – founded in 1909 – is the nation's leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and to promoting the overall mental health of all Americans. Our work is driven by our commitment to promote mental health as a critical part of overall wellness, including prevention services for all, early identification and intervention for those at risk, integrated care, services, and supports for those who need it, with recovery as the goal.