Nemours Children’s Health and the State of Delaware launch a new payment model for kids in the state’s Medicaid program.
This new model has payment incentives based on Nemours being able to help children stay healthy and avoid hospital treatment instead of reimbursing Nemours for treating children.
Kara Walker is Nemours Chief Population Health Officer.
"This payment model is centered around the 120,000 children who are covered by Delaware's Medicaid, and it helps to actually reorient the way that Nemours is paid. It helps to focus on being paid for creating health. This is truly a first ever pediatric global revenue budget model in the entire country," said Walker.
This arrangement incentivizes Nemours to address not only medical drivers of children’s health but also non-medical drivers in an effort to avoid unnecessary medical expenses.
This latest step in Nemours whole child health model helps to consider both a child’s medical needs and the social and community issues that impact their health.
She says this moves away from the traditional model where providers earn more money for providing more medical services.
“Other arrangements allow doctors to earn more and hospitals to earn more for providing more services,” said Walker. “We are really trying to go upstream and focus on prevention, what is necessary to keep kids out of the hospital."
Nemours and the state are touting this agreement as a milestone in creating the healthiest generations of children.
This agreement comes after several years of discussions between Nemours, the state, and community partners.
