Our team has produced hundreds of papers, peer-reviewed articles, manuals, and other products on a range of topics related to health care access and service delivery.

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The Eye of the Beholder: A Discussion of Value and Quality From the Perspective of Families of Children and Youth With Special Health Care Needs

Authors: Anderson, B., Beckett, J., Wells, N., Comeau, M.

Date: 2017

Project: The Catalyst Center

Keywords: CYSHCN

There is broad agreement that increasing the cost-effectiveness and quality of health care services, thereby achieving greater value, is imperative given this country’s current spiraling costs and poor health outcomes. However, how individuals or stakeholder groups define value may differ significantly. To date, the consumer perspective has been underrepresented in discussions of value-based strategies such as pay for performance, capitated and bundled payments, and high-deductible health plans, which have been driven primarily by payers and providers. This article will discuss 3 elements of value from the perspective of families of children and youth with special health care needs: the role of families in the delivery of care, consumer perspectives on what constitutes quality for children and youth with special health care needs, and health care and health care financing literacy, decision-making, and costs. The undervalued contributions made by family members in the delivery and oversight of pediatric care and the importance of partnering with them to achieve the goals of the Triple Aim are stressed. The article closes with a discussion of recommendations for a future policy and research agenda related to advancing the integration of the consumer perspective into value-based purchasing and value-based insurance design.

This article was part of a May 2017 supplement in Pediatrics, produced by the Catalyst Center and the American Academy of Pediatrics (AAP). The Catalyst Center staff along with colleagues from the AAP presented a webinar with key highlights from each of the Pediatrics supplement papers.  

Statement of the Problem: Health Reform, Value-Based Purchasing, Alternative Payment Strategies, and Children and Youth with Special Health Care Needs

Authors: Bachman, S., Comeau, M., Long, T.

Date: 2017

Project: The Catalyst Center

Keywords: CYSHCN, Financing

With the increasing emphasis on value-based purchasing (VBP), policymakers must critically analyze the potential impact for children and youth with special health care needs (CYSHCN), because this group of children, by definition, uses more health care services than other children and inevitably incurs higher per person costs. We provide a history and definition of VBP and insurance design, noting its origin in employer-sponsored health insurance, and discuss various financing and payment strategies that may be pursued under a VBP framework. The relevance of these approaches for CYSHCN is discussed, and recommendations for next steps are provided. There is considerable work to be done if VBP strategies are to be applied to CYSHCN. Issues include the low prevalence of specific special health care need conditions, how to factor in a life course perspective, in which investments in children’s health pay off over a long period of time, the marginal savings that may or may not accrue, the increased risk of family financial hardship, and the potential to exacerbate existing inequities across race, class, ethnicity, functional status, and other social determinants of health.

This article was part of a May 2017 supplement in Pediatrics, produced by the Catalyst Center and the American Academy of Pediatrics (AAP). The Catalyst Center staff along with colleagues from the AAP presented a webinar with key highlights from each of the Pediatrics supplement papers.  

Refining Our Understanding of Value-based Insurance Design and High Cost Sharing on Children

Authors: Ellis, R., Bachman, S., Tan, H.

Date: 2017

Project: The Catalyst Center

Keywords: CYSHCN, Financing

There is significant concern about the financial burdens of new insurance plan designs on families, particularly families with children and youth with special health care needs (CYSHCN). With value-based insurance design (VBID) plans growing in popularity, this study examined the implications of selected VBID cost-sharing features on children.

This article was part of a May 2017 supplement in Pediatrics, produced by the Catalyst Center and the American Academy of Pediatrics (AAP). The Catalyst Center staff along with colleagues from the AAP presented a webinar with key highlights from each of the Pediatrics supplement papers.  

A Primer on Value-based Strategies for Improving Financing of Care for Children and Youth with Special Health Care Needs

Authors: Comeau, M., Bachman, S.

Date: 2017

Project: The Catalyst Center

Keywords: CYSHCN, Financing, Health Reform, Maternal and Child Health

Value-based purchasing and value-based insurance design are gaining increasing attention as strategies for reducing health care spending and improving health outcomes – “value” being the operative concept. However, there is not enough evidence to date regarding the effectiveness of these strategies; what does exist is primarily focused on interventions impacting adults. This primer focuses on opportunities to increase value in spending on health services for children and youth with special health care needs (CYSHCN) through select alternative payment mechanisms and delivery innovations, and potential roles for Title V and family leaders in these efforts.

Leveraging Title V Partnerships to Advance National Performance Measure # 15: Adequate Health Insurance

Authors: Dworetzky, B.

Date: 2017

Project: The Catalyst Center

Keywords: CYSHCN, Financing, Maternal and Child Health, Oral Health Care

The Maternal and Child Health Bureau (MCHB) encourages state Title V programs to partner with families, consumer groups, and others to advance their chosen National Performance Measures (NPMs). As the MCHB-funded national center for health insurance and financing of care, the Catalyst Center researches and disseminates state-level financing strategies aimed at improving health insurance coverage for children and youth with special health care needs (CYSHCN). Our work aligns with NPM #15: “Adequate Insurance Coverage: percent of children ages 0 through 17 who are adequately insured.” This policy brief describes Title V, family leader organization, and Medicaid partnerships that can help states make progress on improving access to adequate insurance for CYSHCN.