A Conversation on the Effect of Payment Models in Children’s Health Care
Proposed changes in health care payment, from fee-for-service to alternative, risk-sharing payment models, can have a substantial impact on health services for children, especially those with complex care needs. In addition, tying payment to value can increase use of ambulatory and preventive services and encourage creative outreach. However, abrupt changes can interrupt continuity and reduce access to care.
During this webinar, the panel discussed the article, Evolving Federal and State Health Care Policy: Toward a More Integrated and Comprehensive Care-Delivery System for Children with Medical Complexity.
This article is part of a supplement to Pediatrics entitled, “Building Systems that Work for Children with Complex Health Care Needs.”
Carolyn Langer, MD, JD, MPH
Dr. Carolyn Langer is Senior Vice President and Chief Medical Officer of Fallon Health after previously serving as Medical Director from 2005 to 2008. Dr. Langer ensures the quality and cost-effectiveness of health care services, overseeing all activities and operations within Fallon Health’s Care Services department. Previously, Dr. Langer served as Chief Medical Officer at MassHealth and the Director of the Office of Clinical Affairs. In addition, Dr. Langer previously held health care leadership roles with Harvard Pilgrim Health Care, Tufts Health Care Institute, and Blue Cross Blue Shield of Massachusetts. She is also a retired Colonel and former flight surgeon in the Army National Guard.
Joan Alker, M. Phil.
Joan Alker is Executive Director of the Center for Children and Families and a Research Professor at the Georgetown University McCourt School of Public Policy. Her work focuses on health coverage for low-income children and families, with an emphasis on Medicaid, the Children’s Health Insurance Program and the Affordable Care Act. She authors an annual report on the nation’s progress on covering children. In addition, she writes about a range of issues including Medicaid waivers, premium assistance, and was the principal investigator of a multi-year study on Florida’s Medicaid program.
Margaret Kirkegaard, MD, MPH
Dr. Margaret Kirkegaard is a principal with Health Management Associates (HMA). Her work with HMA has included several projects focusing on maternal-child health including models of behavioral health integration, child-focused health homes, care management for children with special needs, foster care, and serving as an evaluator for the CMS Strong Start for Mothers and Newborns Initiative. Dr. Kirkegaard also served as the medical director of Illinois’ state-wide, start-up primary care case management program for 1.8 million Medicaid clients. In 2017, Dr. Kirkegaard was appointed by Governor Rauner to serve on the Illinois State Board of Health.
Christopher Stille, MD, MPH
Dr. Christopher Stille is professor of pediatrics and section head of General Academic Pediatrics at the University of Colorado School of Medicine and Children's Hospital Colorado. The primary focus of his research has been improving communication and coordinated care for CYSHCN between primary care clinicians, subspecialists, and family members. He has led projects funded by the U.S. Maternal and Child Health Bureau, the Robert Wood Johnson Foundation, and local and regional funders to pursue this investigation.