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Pediatric accountable health communities: Insights on needed capabilities and potential solutions

G.X. Wang, H.R. Frank, T.S. Santanam, E. Zeng, M. Vulimiri, M. McClellan, C.A. Wong

Background: Pediatric accountable health communities (AHCs) are emerging collaborative models that integrate care across health and social service sectors. We aimed to identify needed capabilities and potential solutions for implementing pediatric AHCs.

Methods: We conducted a directed content analysis of responses to a Request for Information (RFI) from the Center for Medicare & Medicaid Innovation on the Integrated Care for Kids Model (n = 1550 pages from 202 respondents). We then interviewed pediatric health policy stakeholders (n = 18) to further investigate responses from the RFI. All responses were coded using a consensual qualitative research approach in 2019.

Results: To facilitate service integration, respondents emphasized the need for cross-sector organizational alignment and data sharing. Recommended solutions included designating "Bridge Organizations" to operationalize service integration across sectors and developing integrated data sharing systems. Respondents called for improved validation and collection methods for data relating to school performance, social drivers of health, family well-being, and patient experience. Recommended solutions included aligning health and education data privacy regulations and utilizing metrics with cross-sector relevance. Respondents identified that mechanisms are needed to blend health and social service funding in alternative payment models (APMs). Recommended solutions included guidance on cross-sector care coordination payments, shared savings arrangements, and capitation to maximize spending flexibility.

Conclusions: Pediatric AHCs could provide more integrated, high-value care for children. Respondents highlighted the need for shared infrastructure and cross-sector alignment of measures and financing.

Wang GX, Frank HR, Santanam TS, Zeng E, Vulimiri M, McClellan M, Wong CA. Pediatric accountable health communities: insights on needed capabilities and potential solutions. Healthc (Amst). 2020 Dec;8(4):100481. doi: 10.1016/j.hjdsi.2020.100481. Epub 2020 Oct 7. PMID: 33038579.

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