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Alternative Payment Models and Working with Payers-Key Considerations for Advancing Population Health Goals and
Rachel L J Thornton1, Karen M Wilding2, Daniella Gratale3
1Nemours Children's Health, 1201 15th Street Northwest, Suite 520, Wilmington, DE, USA.
Abstract:
This article summarizes approaches to achieving value-based care in Pediatrics, providing a framework for understanding the continuum of models from fee-for-service to advanced alternative payment models. We present key examples of how alternative payment models have been developed and applied at the federal level within Medicare through the work of the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicaid and Medicaid Innovation (CMMI). We further describe key lessons learned and opportunities to adapt value-based payment models to promote whole child health and equity. Finally, we summarize policy considerations and challenges in achieving accountability and aligning financial incentives for children's health within a complex payer landscape.
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