Redesigning Provider Payments to Reduce Long-Term Costs by Promoting Healthy Development image

National Academy of Medicine, April 20, 2018
Nathaniel Z. Counts (Student Fellow alumnus), Neal Halfon, Kelly J. Kelleher, J. David Hawkins, Laurel K. Leslie, Thomas F. Boat, Mary Ann McCabe

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Cognitive, aff ective, and behavioral health (CAB) conditions are among the costliest and fastest growing in the United States. An array of interventions is demonstrated to be eff ective in preventing or mitigating these conditions and off ers the possibility of lower costs and improved lifelong health. These eff ective interventions have not been widely integrated into health care, and current health care reform eff orts have spurred limited additional uptake. Redesigning incentives to maximize life course CAB health is critical to reducing health costs and improving population health. Future health care reform eff orts will need to redesign incentives by developing quality measures of CAB developmental outcomes for accountability, creating payment methodologies based on the expected value of changes in these outcomes, and ensuring suffi cient reimbursement. These three changes would allow for timely incentives for eff ectively promoting life course CAB health and potentially reducing future health system spending. Health care reforms will also need to engage other sectors that contribute to and help optimize CAB health, including child care and education.

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health care finance health care reform public health