Schuyler Center for Analysis and Advocacy

Grant Date: 01.20.2016
Amount: $61,708

To help ensure that the unique health needs of children are considered in New York’s health care reform efforts, by assessing the impact on child health of various approaches to value-based payment, and disseminating findings to policymakers and other stakeholders.

New York’s Medicaid program is in the middle of a significant transformation, in which substantial populations and services are moving into managed care, and the Medicaid payment system is being adjusted to reward the value of health care services over the volume of services. 

Discussions in New York State about the move to value-based payment have primarily focused on high-cost conditions, high-volume services, and high-need adult populations.  Children, a generally low-cost population with relatively few avoidable hospitalizations compared to their adult Medicaid-insured counterparts, have not been a focus of discussions.  However, focusing only on adults poses the risk of creating a system that ignores the developmental trajectory of children and the opportunity for health care providers to address developmental and other challenges that have significant effects on children’s long term physical health, mental health, and cognitive outcomes.

Through research, analyses, and interviews with stakeholders, including policy makers, providers, insurers, and academics, the project team will examine which value-based approaches may be applicable to payment for services provided to Medicaid-insured children—and will then produce and disseminate a final report.