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June 2018

Making the Case for Value-Based Payment Reform in Children’s Health Care

Author Affiliations
  • 1Department of Pediatrics, Margolis Center for Health Policy, Duke Clinical Research Institute, Duke University, Durham, North Carolina
  • 2Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts
  • 3Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
  • 4Margolis Center for Health Policy, Duke University, Durham, North Carolina
JAMA Pediatr. 2018;172(6):513-514. doi:10.1001/jamapediatrics.2018.0129

Child and adolescent health in the United States continues to lag behind that of other industrialized nations, with the US health care system falling short in tackling current threats (eg, childhood obesity and substance use epidemics) as well as future threats (eg, rising adult health disparities that may reflect adverse childhood influences). The emphasis on short-term financial returns partly explains this failure insofar as well-being outcomes for children are best measured over the long term. Attracting the attentions of payers and policy makers to increased and innovative funding for children’s health care has been difficult, as more costly adult needs often overshadow child-specific needs. The move toward value-based payment reform presents a critical opportunity for children’s health providers to make the case for the value of high-quality children’s health care, which warrants increased resources, and payment models that are specifically designed to improve children’s short- and long-term health and well-being outcomes.