Innovative new framework for organizing care to meet all family members’ needs holds promise for improved health and lower costs
NEW YORK, NEW YORK March 21, 2019—In a report released today, United Hospital Fund laid out strategies for clinicians and payers to improve children’s health by providing “integrated family care”—seamless, effective health care that addresses all a family’s health needs, including socio-economic factors that impact health.
The report, Plan and Provider Opportunities to Move Toward Integrated Family Health Care, presents a framework for health care providers and insurers to use primary care as a launching pad for ensuring that the health needs of all family members are met through integrated services. The report introduces the idea of “integrated family care” as a goal for the nation’s health care systems and payers and provides pragmatic recommendations for how health care can move toward that goal.
The “integrated family care” concept relies on a strong foundation of health insurance coverage, builds on delivery system transformation efforts toward patient and family-centered care, and leverages existing approaches like maternal depression screening during well-child visits.
“Many of the nation’s leading clinicians see the need to reduce fragmented care for families and have been pushing toward more integrated care in their own communities,” said Suzanne Brundage, report co-author and director of UHF’s Children’s Health Initiative. “The challenge, however, has been harnessing delivery system and payment transformation to support these ideas.”
It has long been recognized that family dynamics can influence the health of children in profound ways. Evidence also suggests the health of multiple generations of a family can be improved through family-focused interventions, especially those that integrate services that address the social, economic, and behavioral factors that can affect health. And family interventions that better manage or prevent health issues in children can improve the outcomes for not only the family’s youngest members, but their caregivers as well. For example, a review of physician-led family support programs for adolescents with mental health conditions found positive benefits for caregiver mental health and parenting skills, in addition to improved mental health for the child.
Investments in early childhood health and development can also yield a significant return on investment over the long-term, while improving family health may generate immediate savings to help justify those investments. “As health systems and insurers, including Medicaid programs, seek to improve health outcomes and control rising health care costs, it is time to think about how a family-based approach to care can contribute,” said co-author Chad Shearer, UHF vice-president for policy and director of UHF’s Medicaid Institute.
The report’s framework helps payers and providers conceptualize the types of changes they can introduce to encourage integrated family care. Among those changes: making the family a partner in decisions about the care of individual members; inquiring about the health of family members other than the patient and offering interventions or referrals if necessary; and focusing care coordination and alternative payment models on the improvement of family outcomes.
The nation is a long way from integrated family care, and significant barriers need to be overcome, including the absence of care coordination structures and financial incentives focused on families. The report lists a number of opportunities for surmounting these obstacles and calls on all members of the health sector to commit to developing a family-centered health system.
The publication is supported by a Cooperative Agreement awarded to ChangeLab Solutions and funded by the Centers for Disease Control and Prevention. It can be downloaded from UHF’s website here.
About United Hospital Fund
United Hospital Fund works to build a more effective health care system for every New Yorker. An independent, nonprofit organization, we analyze public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more on our initiatives and programs please visit our website at www.uhfnyc.org and follow us on Twitter.