Health care payers, providers, and policymakers are increasingly pursuing value-based payment (VBP) models that explicitly incentivize high-quality care. With 38 percent of children in the U.S. covered by Medicaid, there is an opportunity for states to implement VBP models focused on child health ― potentially impacting outcomes later in life and generating societal savings in the long run.
Massachusetts’ Medicaid program, MassHealth, launched its accountable care organization program in 2018 to serve both children and adults. To inform Massachusetts’ efforts in prioritizing investment in pediatric care, the Center for Health Care Strategies (CHCS), in partnership with the Massachusetts Medicaid Policy Institute, a program of the Blue Cross Blue Shield of Massachusetts Foundation, examined how states and providers across the country are addressing child health through VBP programs.
This report provides examples of Medicaid VBP models serving children, identifies key themes related to implementing VBP models for children and policy considerations to help Massachusetts better meet children’s needs. While the report is oriented to the Massachusetts landscape, the lessons can inform payers and providers in other states seeking to design and enhance VBP models for children.