Keywords

value-based payments, Medicaid, children, healthcare quality

 

Authors

  1. Peele, Pamela
  2. Keyser, Donna
  3. Lovelace, John
  4. Moss, Deborah

Abstract

Population health management (PHM) approaches to improve cost and quality remain limited. To address this gap, stakeholders within an integrated delivery and financing system in Western Pennsylvania designed, implemented, and tested a value-based care model for children with medically complex conditions that could be scaled across the broader pediatric population. The model included: (1) a multilevel, interdisciplinary infrastructure; (2) actionable analytics reports to guide continuous quality improvement; (3) alternative provider payments; (4) consumer-directed spending accounts; and (5) shared savings with practices. Four practices caring for 215 children (