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Moving From Spending to Investment: A Research Agenda for Improving Health Care Financing for Children and Youth With Special Health Care Needs

期刊

ACADEMIC PEDIATRICS
卷 22, 期 2, 页码 S47-S53

出版社

ELSEVIER SCIENCE INC

关键词

children and youth with special health care needs; health insurance; quality measures; research agenda; value-based payment reform

资金

  1. Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under Children and Youth with Special Health Care Needs Research Network [UA6MC31101]
  2. Lucile Packard Foundation for Children's Health, Palo Alto, California
  3. Lucile Packard Foundation for Children's Health's Program for Children with Special Health Care Needs
  4. Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)

向作者/读者索取更多资源

Children and youth with special health care needs use more health care resources and their unique needs deserve additional consideration. Current health care spending is focused on acute illnesses and payment reform should shift away from fee-for-service and aim to lower costs. However, there is a lack of prioritization for investment in children's health and research is needed to determine where and how spending should be targeted.
Children and youth with special health care needs (CYSHCN) use disproportionately more health care resources than non-CYSHCN, and their unique needs merit additional consideration. Spending on health care in the United States is heavily concentrated on acute illnesses through fee-for-service (FFS). Payment reform frameworks have focused on shifting away from FFS, addressing health outcomes and the experience of care while lowering costs, particularly for high resource utilizers. The focus of payment reform efforts to date has been on adults with chronic illnesses, with less priority given to investment in children's health and life course. Spending for children's health is also considered an investment in their growth and development with long-term outcomes at stake, so research questions should focus on where and how such spending should be targeted. This paper discusses high-priority research topics in the area of health care financing for CYSHCN in the context of what is currently known and important knowledge gaps related to investment for CYSHCN. It proceeds to describe 3 potential research projects that can address these topics, following a framework informed by the priority questions identified in a previous multistakeholder research agenda development process. We focus on 3 areas: benefits, payment models, and quality measures. Specific aims and hypotheses are offered, as well as suggestions for approaches and thoughts on potential implications.

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