{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:06:59Z","timestamp":1788336419715,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100005227","name":"Centers for Medicare and Medicaid Services","doi-asserted-by":"publisher","award":["CMS 2B2-20-001"],"award-info":[{"award-number":["CMS 2B2-20-001"]}],"id":[{"id":"10.13039\/100005227","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Care Res Rev"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>Pediatric value-based payment reform has been hindered by limited return on investment (ROI) for child-focused measures and the accrual of financial benefits to non-health care sectors. States participating in the federally-funded Integrated Care for Kids (InCK) models are required to design child-centered alternative payment models (APMs) for Medicaid-enrolled children. The North Carolina InCK pediatric APM launched in January 2023 and includes innovative measures focused on school readiness and social needs. We interviewed experts at NC Medicaid managed care organizations, NC Medicaid, and actuaries with pediatric value-based payment experience to assess the NC InCK APM design process and develop strategies for future child-focused value-based payment reform. Key principles emerging from conversations included: accounting for payer priorities and readiness to implement measures; impact of data uncertainty on investment in novel measures; misalignment of a short-term ROI framework with whole child health measures; and state levers like mandates and financial incentives to promote implementation.<\/jats:p>","DOI":"10.1177\/10775587231217178","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T07:51:17Z","timestamp":1703836277000},"page":"259-270","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Investing in Child Health Through Alternative Payment Models: Lessons From North Carolina Integrated Care for Kids"],"prefix":"10.1177","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2030-9964","authenticated-orcid":false,"given":"Greeshma","family":"James","sequence":"first","affiliation":[{"name":"Duke Margolis Center for Health Policy, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Kasper","sequence":"additional","affiliation":[{"name":"North Carolina Department of Health and Human Services, Raleigh, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene A.","family":"Wong","sequence":"additional","affiliation":[{"name":"North Carolina Department of Health and Human Services, Raleigh, USA"},{"name":"Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA"},{"name":"North Carolina Integrated Care for Kids, Durham, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Duke Margolis Center for Health Policy, Durham, NC, USA"},{"name":"North Carolina Integrated Care for Kids, Durham, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Allin","sequence":"additional","affiliation":[{"name":"Duke Margolis Center for Health Policy, Durham, NC, USA"},{"name":"North Carolina Integrated Care for Kids, Durham, USA"},{"name":"Manatt, Phelps & Phillips, LLP, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Steiner","sequence":"additional","affiliation":[{"name":"North Carolina Integrated Care for Kids, Durham, USA"},{"name":"Department of Pediatrics, The University of North Carolina at Chapel Hill School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kori B.","family":"Flower","sequence":"additional","affiliation":[{"name":"North Carolina Integrated Care for Kids, Durham, USA"},{"name":"Department of Pediatrics, The University of North Carolina at Chapel Hill School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kimberg","sequence":"additional","affiliation":[{"name":"North Carolina Integrated Care for Kids, Durham, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rushina","family":"Cholera","sequence":"additional","affiliation":[{"name":"Duke Margolis Center for Health Policy, Durham, NC, USA"},{"name":"Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA"},{"name":"North Carolina Integrated Care for Kids, Durham, USA"},{"name":"Department of Population Health Sciences, Duke University, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"bibr1-10775587231217178","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1514649"},{"key":"bibr2-10775587231217178","doi-asserted-by":"publisher","DOI":"10.1177\/104973230201200611"},{"key":"bibr3-10775587231217178","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S165576"},{"issue":"9","key":"bibr4-10775587231217178","first-page":"399","volume":"24","author":"Berkowitz S. A.","year":"2018","journal-title":"The American Journal of Managed Care"},{"key":"bibr5-10775587231217178","volume-title":"Value-based payment to support children\u2019s health and wellness: Shifting the focus from short-term to life course impact","author":"Brykman K.","year":"2021"},{"key":"bibr6-10775587231217178","doi-asserted-by":"publisher","DOI":"10.1080\/14697010500359250"},{"key":"bibr7-10775587231217178","unstructured":"Coordinated care: Key to successful outcomes. (2019). Consensus Health. https:\/\/www.consensushealth.com\/wp-content\/uploads\/2019\/02\/Care-Coordination-Best-Practices_CONSENSUS_2019-compressed.pdf"},{"key":"bibr8-10775587231217178","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-4037"},{"key":"bibr9-10775587231217178","unstructured":"Crook H., Zheng J., Bleser W. K., Whitaker R. G., Masand J., Saunders R. S. (2021). How are payment reforms addressing social determinants of health? 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(2013). Qualitative methods in rapid turn-around health services research. VA HSR&D National Cyberseminar Series: Spotlight on Women\u2019s Health. https:\/\/www.hsrd.research.va.gov\/for_researchers\/cyber_seminars\/archives\/video_archive.cfm?SessionID=780"},{"key":"bibr18-10775587231217178","unstructured":"Integrated Care for Kids (InCK) model. (2022). Centers for Medicare & Medicaid Services. https:\/\/innovation.cms.gov\/innovation-models\/integrated-care-for-kids-model"},{"key":"bibr19-10775587231217178","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13641"},{"key":"bibr20-10775587231217178","volume-title":"Caring for the whole child: A new way to finance initiatives to improve children\u2019s health","author":"Mann C.","year":"2020"},{"key":"bibr21-10775587231217178","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-020-03101-3"},{"key":"bibr22-10775587231217178","unstructured":"National Academy of Medicine. (2022, June 8). 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