Converting to a system that pays for health rather than sickness is a long-term vision for our organization.
WILMINGTON, Del.– Nemours’ ongoing approach to transform the health system’s Delaware operations toward an expanded vision of health, including a value-based payment model, are the focus of an article published today in the November issue of Health Affairs, the country’s most respected health policy journal. As a hallmark of these efforts, Nemours has established a value-based care organization in Delaware that is designing a system to reward health outcomes for children.
“Converting to a system that pays for health rather than sickness is a long-term vision for our organization,” said R. Lawrence Moss, MD, president and CEO of Nemours Children’s Health System. “We have made remarkable progress in Delaware, in part because of strong partners that share our vision for improving the health of the state’s children.”
The article describes Nemours’ multi-pronged strategy to move toward value-based care which includes an emphasis on children’s health outcomes, changing insurance reimbursement, and investing in broad prevention efforts. A seminal focus of this work is Nemours’ Value-Based Services Organization (VBSO). Through the structure of the VBSO and other efforts, Nemours is moving to take on financial risk so that the organization is reimbursed based on children’s health. In this work, the health system is using data analytics to factor in population health, clinical metrics, predictive models, medical expenses, social determinants of health, and health disparities.
Among the innovations cited in Health Affairs are the clinically integrated network Nemours is developing with primary care providers to better track and standardize care and outcomes, and its work with the state’s Medicaid delivery model. Supporting this work is Nemours’ prevention-focused policy and advocacy efforts that aim to address social determinants of health for patients and their families, as well as through broader policy changes that impact the health of the entire geographic community. Social determinants include factors such as food security, good nutrition, literacy, high quality education, housing, and protection from poverty, violence and other adverse childhood experiences.
“This work requires coordinated effort on all fronts to accept risk, work with payers, and continue prevention work,” said Moss. “It is meaningful, innovative work and it’s gathering momentum.”
Read the article here: https://bit.ly/36i1WLz
About Nemours Children’s Health System
Nemours is an internationally recognized children's health system that owns and operates the two free-standing children’s hospitals: the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., and Nemours Children's Hospital in Orlando, Fla., along with outpatient facilities in five states, delivering pediatric primary, specialty and urgent care. Nemours also powers the world’s most-visited website for information on the health of children and teens, KidsHealth.org, and offers on-demand, online video patient visits through Nemours CareConnect. Nemours ReadingBrightstart.org is a program dedicated to preventing reading failure in young children, grounded in Nemours’ understanding that child health and learning are inextricably linked, and that reading level is a strong predictor of adult health.
Established as The Nemours Foundation through the legacy and philanthropy of Alfred I. duPont, Nemours provides pediatric clinical care, research, education, advocacy and prevention programs to families in the communities it serves.