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Related Concept Videos

Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Standards of Care I01:22

Standards of Care I

Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Standards of Care II01:19

Standards of Care II

Nurses bear specific legal responsibilities under several federal statutes, including:
Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...

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Related Experiment Video

Updated: May 15, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
14:43

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

Beyond Medicare ACOs: Pediatric Alternative Payment Models and Financial Risk-Sharing.

Eli Sprecher1, James M Perrin2

  • 1Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Pediatrics
|May 13, 2026
PubMed
Summary
This summary is machine-generated.

Pediatric clinicians should carefully consider alternative payment models (APMs) due to unique child health care challenges. Tailored APMs are crucial for financial accountability and innovation in pediatric care.

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Last Updated: May 15, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
14:43

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

Area of Science:

  • Health Services Research
  • Pediatric Health Policy
  • Value-Based Care

Background:

  • Alternative payment models (APMs) are increasingly proposed for pediatric care, drawing from adult Medicare models.
  • Key differences in pediatric healthcare, including cost structures and patient populations, limit direct applicability of adult APMs.
  • Challenges include limited short-term savings, high spending driven by complex cases, coverage instability, and lack of pediatric-specific data.

Purpose of the Study:

  • To analyze the suitability of current APMs for pediatric care.
  • To identify limitations of adult-based APM designs in the pediatric context.
  • To propose essential design features for pediatric-appropriate APMs.

Main Methods:

  • Review of evidence base for APMs in healthcare.
  • Analysis of how selection, benchmarking, and coding practices affect savings in adult APMs.
  • Identification of pediatric-specific factors complicating APM implementation.
  • Outline of necessary design elements for pediatric APMs.

Main Results:

  • Adult APM savings may be overstated due to specific practices, which may not translate to pediatrics.
  • Pediatric APMs require unique features like multi-year baselines, exclusion of certain costs, and robust risk protections.
  • Child health spending is volatile, driven by complex cases, and affected by coverage churn.

Conclusions:

  • Pediatric clinicians must cautiously adopt downside risk APMs, ensuring alignment with clinical influence and infrastructure.
  • Poorly designed pediatric APMs risk destabilizing care systems and access.
  • Well-designed, tailored APMs can foster innovation in prevention-focused, team-based pediatric care.