Paediatric alternative payment models: emerging elements

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. 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.

Automated summary

This review aims to summarize the elements of emerging paediatric alternative payment models (APMs), strategies to overcome implementation barriers, and policy approaches. The development of paediatric value-based care and APMs should consider the unique health needs of children and adolescents. The adoption of paediatric APMs is hindered by the longer time needed to achieve cost savings, limited existing model tests, and challenges with cross-sector data-sharing and pooled financing.