PEDIATRICS Volume 141, number s3, March 2018:e20171284 SUPPLEMENT ARTICLE Evolving Federal and State Health Care Policy: Toward a More Integrated and Comprehensive Care-Delivery System for Children With Medical Complexity Carolyn S. Langer, MD, JD, MPH, a Richard C. Antonelli, MD, MS, b Lisa Chamberlain, MD, MPH, c Richard J. Pan, MD, MPH, d David Keller, MD e a Office of Clinical Affairs, Commonwealth Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; b Boston Children’s Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts; c School of Medicine, Stanford University, Stanford, California; d State Senate, Sacramento, California; and e Children’s Hospital Colorado, School of Medicine, University of Colorado, Aurora, Colorado Drs Langer and Keller conceptualized and designed the article and drafted the initial manuscript; Drs Antonelli, Chamberlain, and Pan designed the article and drafted the initial manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. DOI: https://doi.org/10.1542/peds.2017-1284K Accepted for publication Nov 1, 2017 Address correspondence to Carolyn S. Langer, MD, JD, MPH, Office of Clinical Affairs, Commonwealth Medicine/University of Massachusetts Medical School, 333 South St, Shrewsbury, MA 01545. E-mail: carolyn.langer@umassmed.edu PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Irrespective of any future changes in federal health policy, the momentum to shift from fee- for-service to value-based payment systems is likely to persist. Public and private payers continue to move toward alternative payment models that promote novel care-delivery systems and greater accountability for health outcomes. With a focus on population health, patient-centered medical homes, and care coordination, alternative payment models hold the potential to promote care-delivery systems that address the unique needs of children with medical complexity (CMC), including nonmedical needs and the social determinants of health. Notwithstanding, the implementation of care systems with meaningful quality measures for CMC poses unique and substantive challenges. Stakeholders must view policy options for CMC in the context of transformation within the overall health system to understand how broader health system changes impact care delivery for CMC. abstract by guest on May 29, 2020 www.aappublications.org/news Downloaded from