Pediatric Alternative Payment Model Opportunities
CMS issues Request for Information
In partnership with states and providers, the Centers for Medicare & Medicaid Services (CMS) plays a leading role in safeguarding the health of America’s future by providing coverage for more than one in three American children. Through Medicaid and the Children’s Health Insurance Program’s (CHIP) mandatory and optional benefits, children receive access to a spectrum of comprehensive and preventive health care services aimed at providing a sound start for lifelong health. As a result, children enrolled in Medicaid and CHIP lead the nation in participation in preventive care and access to needed care.
CMS and states have also demonstrated consistent commitment to improving the health of children through care redesign and innovation in programs such as Medicaid Health Homes, the Medicaid Innovation Accelerator Program, the State Innovation Models Initiative and Strong Start for Mothers and Newborns Initiative. Building on these efforts, the CMS Innovation Center, in partnership with the Center for Medicaid and Chip Services (CMCS), is releasing a Request for Information (RFI) seeking input on the design of alternative payment models focused on improving the health of children and youth covered by Medicaid and CHIP. As the insurer of a third of the nation’s children and a leader in health care innovation, CMS is uniquely positioned to improve the health of America’s children.
Through the RFI, input is being sought on approaches to improve the quality and reduce the cost of care for children and youth enrolled in Medicaid and CHIP. In particular, concepts are being explored that encourage pediatric providers to collaborate with health-related social service providers (e.g., early childhood development programs, child welfare services, and home and community based service providers) at the state and local levels and share accountability for health outcomes for children and youth enrolled in Medicaid and CHIP.
CMS seeks input through the RFI from the broad community of child and youth-focused stakeholders on concepts critical to addressing the comprehensive health needs of children and youth, such as:
- Opportunities and impediments to extending and enhancing integrated service model concepts like accountable care organizations (ACOs) to the pediatric population;
- Flexibilities and supports states and providers may need in order to offer such models of care to a state’s pediatric population; and
- Approaches for states and providers to coordinate Medicaid and CHIP benefits and waivers with other health-related social services for children and youth.
To be assured consideration, please submit comments to HealthyChildrenandYouth@cms.
hhs.gov by 11:59 p.m. EDT March 28, 2017.
- Request for Information (RFI) (PDF)
- Medicaid Health Homes
- Medicaid Innovation Accelerator Program
- State Innovation Models Initiative
- Strong Start for Mothers and Newborns Initiative
For more information on AHRQ’s role in CHIPRA, visit http://www.ahrq.gov/
For more information on the CHIPRA Quality Demonstration Grant projects and the national evaluation, visit: http://www.ahrq.gov/
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