You Get What You Pay for: Measuring Quality in Value-Based Payment for Children's Health Care

See the related press release.

Value-based payment arrangements are an important tool that New York's Medicaid program is using in its efforts to move away from fee-for-service payment systems. Most of the arrangements underway so far measure value in terms of care for adults; a different yardstick will be necessary when incorporating children's health care into this reform effort.

You Get What You Pay for examines the quality measures and outcomes that could be used in value-based payment arrangements for children's health care in New York. An important distinction when deciding what measures to use is the way in which children's health and health care services differ from adult health care: the centrality of prevention efforts in children's health, the relatively small number of children with special health care needs, and the confounding effects of different developmental stages throughout childhood.

Three case studies in the report show how innovative payers and providers in other states have recently worked to incorporate child-focused measures in their own value-based payment arrangements. Some of the lessons to be gleaned from other states' experiences are about the specific measures chosen, and some are about the process by which states can address other ambitious goals.

Support for this work was provided by the New York State Health Foundation.