Last week, the Centers for Medicare and Medicaid Services (CMS) announced its investment in a new grant program to test innovative approaches to improving children’s health. The program, Integrated Care for Kids (InCK), will provide funding for up to eight states to design and implement one or more child-focused models of care. These projects, which will last seven years, will aim to improve child health outcomes, reduce avoidable inpatient stays and out-of-home placements and create sustainable alternative payment models.
CMS specifically intends these projects to focus on addressing children’s behavioral health needs including opioid or other substance use issues. Young people are in a critical window of vulnerability to substance misuse and addiction. This program will help state Medicaid programs expand substance use prevention and treatment, keeping kids on a healthy path to avoid the destructive consequences of drug and alcohol problems.
Up to this point, value-based payment efforts have generally focused on groups who experience higher health care costs. Since children are typically healthy, there has not been much attention given to children’s needs. Designing alternative payment models for children has also proved challenging because the cost savings often come many years later and may show up as savings in other sectors. However, we know that children are not little adults. Therefore, it is important to create health systems that align with their particular social, emotional, physical and mental health needs. Providing states with the resources to design and implement a payment and delivery system that integrates the work of providers across behavioral health, physical health and other child serving agencies will ensure that the particular needs of children and families are met.
Since the focus of this program will be on children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP), it is also a tremendous opportunity to influence the social determinants of health and address health equity. These alternative payment model pilots will serve many children of color. Of the nearly 46 million children enrolled in Medicaid and CHIP, approximately two-thirds of them are children of color. Data show children of color experience more traumatic events than their white peers. These adverse childhood experiences (ACEs) influence brain development and can have lifelong impacts on physical, mental and behavioral health. This new approach means states will be able to prioritize listening to and acting on the expertise of children and families who may have had negative experiences with health and social service systems due to racism or other factors. Developing alternative payment models with the goal of ameliorating these challenges will help ensure that all children and families thrive.