Promoting Comprehensive Healthcare Delivery for Children

Health Update

Editor’s Note: The Center for Medicare and Medicaid Innovation (CMMI) will fund a model of care, Integrated Care for Kids (InCK), that will test whether alternative payment models can promote closer integration across children’s physical healthcare, behavioral healthcare, social services and educational services in up to eight states. In a post for The Commonwealth Fund’s To the Point blog, summarized below, Manatt Health explains how InCK provides an important opportunity for states and their local partners to improve children’s health outcomes and well-being. Click here to read the full post.

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InCK, a new federal initiative, encourages healthcare providers and Medicaid agencies to think beyond medical services, supporting team-based care with family representation and focusing on children’s social and emotional development. CMMI will offer about $15 million in funding to awardees, which will include a local organization lead—such as a provider that works extensively with children who have behavioral health issues—and/or a Medicaid agency partnering with a broad range of social and educational organizations that serve children.

The new model signals CMMI’s interest in delivery system reforms focused on children. Until recently, children have been at the back of the line when it comes to reform efforts, behind costly adult populations that drive the vast majority of Medicaid and Medicare spending. With InCK, the federal government is opening the door wider for reform of children’s healthcare delivery. InCK includes a number of notable features:

  • Thinking beyond medical services. Under the InCK model, states and a local partner—such as a child-focused health or social service provider—will coordinate services for children across healthcare and other settings. A key goal is to help families navigate the many types of services they may be offered, including housing, food and educational assistance. States and their local partners must establish a Partnership Council that includes representatives from physical health systems; behavioral health agencies; schools; child welfare agencies; food, housing and other social service agencies; family members; and others.
  • Encouraging team care with family representation. Focused on integrated care, the InCK model calls for coordination and, in particularly serious cases, intensive team-based care to support children. The teams are expected to include family members, educators, social service representatives and others.
  • Focusing on children’s social and emotional development. The model requires states and their local partners to consider children’s social and emotional development. For example, they must incorporate a child’s ability to function in school and engage in social relationships into the criteria used to determine which children they serve and the level of care those children receive.

To succeed, InCK participants will need to pull together the disparate organizations that share a commitment to children but tend to operate independently. Even with this challenge, InCK creates an important opportunity for states and their local partners to improve children’s well- being and perhaps trigger broader interest in integrated service delivery and payment models for children.