Start: December 2019

Funder: Robert Wood Johnson Foundation

The field of child health care delivery has an impressive history of innovation in the United States. This includes the origins of the patient-centered medical home movement; innovative models to promote screening and referral for social needs; and national activities to foster new guidelines and standards of practice, such as those in Bright Futures. This activity, however, is largely disconnected from other health care transformation efforts, with seemingly far less investment in child health system reform than is occurring in adult health care settings. At the same time, across the child health field, there is strong agreement about the fundamental elements necessary to transform pediatric practice. The significant challenges of the past year — the COVID-19 pandemic coupled with a national reckoning regarding racial inequities — amplify the imperative for the child health care field to push transformation to a comprehensive approach that focuses on child and family well-being.

Accelerating Child Health Transformation (ACHT), an initiative led by the Center for Health Care Strategies (CHCS) with support from the Robert Wood Johnson Foundation, is seeking to accelerate the adoption of key elements necessary to advance family-centered pediatric practice. Identified through a comprehensive scan of best practices in the field, the ACHT project is focusing on three key elements necessary for child health transformation:

  1. Adopting anti-racist practices to advance health equity;
  2. Promoting a family-driven, multi-generational approach; and
  3. Addressing social risks and needs to promote resilience.

Widespread adoption of these key elements not only requires capacity building and workflow changes within practice settings, but also new payment and accountability structures to support and sustain these enhanced approaches to care. Accordingly, ACHT will also look to inform the development and implementation of alternative payment methods and approaches to quality measurement that encourage broader adoption of identified best practices.

Project Goals and Activities

Over three years, ACHT will convene leading experts, pediatric providers, and family-led organizations across the nation to accelerate the adoption of anti-racist practices to advance health equity and promote care approaches that are family-driven and address social risks and needs by:

  • Developing a national ACHT learning community that informs and supports the adoption of the key elements;
  • Identifying payment mechanisms and quality measurement strategies that support widespread adoption; and
  • Developing, testing, and disseminating a pediatric transformation toolkit that addresses the practice-level changes and the payment and accountability levers that support them.

The ACHT learning community will provide a platform for peer-to-peer exchange for pediatric practices that are excelling in one or more of the elements necessary for child health transformation, and who are committed to refining and expanding their efforts. The pediatric transformation toolkit will be informed by the learning community and developed in collaboration with subject matter experts and partners in the field.

ACHT will be guided by an advisory group composed of family representatives and key national experts in the pediatric field, including: Renée D. Boynton-Jarrett, MD, ScD, Associate Professor of Pediatrics, Boston University School of Medicine and Founding Director, Vital Village; Charles Bruner, PhD, Network Resource Manager, InCK Marks; Stephanie Doyle, MPH, Senior Associate, Center for the Study of Social Policy; Hala Durrah, MTA, Patient Family Engagement Consultant and Advocate; Gretchen Hammer, MPH, Founder, Public Leadership Group; and Kay Johnson, MPH, MEd, President, Johnson Group Consulting.

Look for future resources and stories coming out of this work to help spread opportunities to facilitate child health transformation in pediatric practices across the nation.