United Hospital Fund Issues Report on Pediatric Primary Care

Friday, January 8, 2016
United Hospital Fund Issues Report on Pediatric Primary Care
According to a new United Hospital Fund report, resolving four key issues is paramount to ensure that each contact a young child has with the health care system not only responds to his or her acute needs but also promotes the child’s full development—including physical, mental, and cognitive health.
The report -  Seizing the Moment: Strengthening Children’s Primary Care in New York  - notes that New York currently has a unique and historic opportunity to improve the overall health and well-being of its youngest residents through a renewed focus on strengthening primary care to make it responsive to the healthy development challenges children face today. Among the factors contributing to this opportune timing are new scientific evidence and consensus about early childhood development and substantial innovation in the field, as well as frequent visits by nearly all young children to primary care settings.
The four issues the report identifies as key next steps to promote broader adoption of pediatric primary care innovations include (1) defining an early childhood development framework for pediatric primary care that brings together the various innovations occurring in pediatric sites across New York, (2) determining how new value-based payment efforts can support effective early childhood development interventions in pediatric practices, (3) specifying the measures and outcomes public and private payers will accept for monitoring investments in early childhood development services, and (4) identifying and resolving operational barriers that prevent pediatricians from using evidence-based approaches to promote healthy development.
While the report’s key steps have implications for all children, it also pays special attention to the more complex issues of children living in poverty—significant because nearly 40 percent of children in the state live in poverty or near poverty.
The report also notes the importance of engaging New York’s major health care reform initiatives that are underway, particularly Medicaid’s transition to value-based payment and the State’s effort to define and make financially sustainable advanced primary care. With quick action, both of these efforts could potentially be leveraged to encourage greater innovation in supporting early childhood development.
“Because of its emphasis on preventing avoidable hospitalizations, health care reform has focused primarily on adults,” notes Suzanne Brundage, senior health policy analyst at UHF and the report’s author. “But for making changes that have long-term benefits on many fronts, pediatric primary care presents one of our greatest opportunities.”
“New Yorkers can be proud of their long-standing commitment—and successes—in supporting all children's access to health care,” said Andrea G. Cohen, senior vice president for program. “But scientific advances suggest that the health care system can do more to leverage that access to promote lifelong health. This opens up a great new opportunity for policymakers—and health leaders—to focus on new ways to improve child health.”
In addition to discussing considerations and challenges for scaling and sustaining innovations to have broad impact on the lives of young children in New York, the report provides an overview of the scientific evidence from a variety of disciplines related to early childhood development. It also presents different approaches currently being used to promote healthy development in pediatric settings in New York and beyond.
“UHF has a long history of work to better understand and promote strong primary care,” said Jim Tallon, president of the United Hospital Fund. “But this report also represents a new UHF effort—exploring approaches expressly to improve child health. As New York’s health care system continues to evolve, we will shed light and lead discussion on how policy and practice reforms can better address the unique needs of children and their families, particularly the lowest-income New Yorkers.”
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