The National Academies

09/19/2024 | Press release | Distributed by Public on 09/19/2024 09:07

New Report Provides Road Map for Policy Changes to Transform Child Health Care and Meet the Challenges of the Youth Health Crisis

Share

New Report Provides Road Map for Policy Changes to Transform Child Health Care and Meet the Challenges of the Youth Health Crisis

News Release| September 19, 2024
WASHINGTON - The current health care system for children is in crisis, says a new report from the National Academies of Sciences, Engineering, and Medicine that lays out a road map for policy change and health care system transformation to better meet the needs of children and families. The report documents increases in the incidence of chronic diseases; growing concerns with children's mental, emotional, and behavioral health; and significant disparities among population groups. Rising rates of mortality and disability among youth and working age Americans illustrate the long-term outcomes of not providing the care that children need.
"Without systemic change, the next 10 years will see more young people entering adulthood with chronic illness, disability, and mental health issues," said Tina Cheng, co-chair of the committee that wrote the report, chair and professor of pediatrics at the University of Cincinnati, and chief medical officer and director of the Cincinnati Children's Research Foundation at Cincinnati Children's Hospital Medical Center. "This will have dramatic effects on quality of life for generations and will leave fewer adults capable of productive work in the years to come."
The National Academies' report centers on the health care sector, defined broadly to include clinical and community care, along with public health and school-based investments in child and family health. The committee looked at child health in a holistic way by including preconception, maternal, prenatal, child, adolescent, family, and community health and well-being.
According to the report even with the nation's expansion in insurance coverage, many children lack access to adequate preventive care. Most models of health care payment rely on fee-for-service structures or value-based arrangements that are designed to lower costs for adult patients, and do not provide child health clinicians with the flexibility or incentives to work with families and partner with communities to fully address their health and developmental needs. The report recommends federal and state policymakers and the Centers for Medicare & Medicaid Services reform Medicaid and the Children's Health Insurance Program (CHIP) to ensure continuous coverage and reduced state and territory variability in services for every child and parent under age 65 who lacks other insurance.
"We need to put kids first in how we think about health care, which will require a whole system transformation," said committee co-chair James Perrin, professor of pediatrics at Harvard Medical School and former director of the Division of General Pediatrics at the MassGeneral Hospital for Children. "National progress on improving long-term outcomes for all Americans will come only from a dedicated and ongoing commitment to improving the well-being of children, youth, and families."
The report's recommendations call for sustained and coordinated leadership at the federal level on children's health and emphasize the need to better assess the impact of public policies on children's health. The committee identified five implementation goals for policy changes, and made recommendations for federal, state, and community action, summarized below.
  • Elevate the importance of child and adolescent health for the nation through continuous public focus on children and youth. Federal policymakers should convene an expert panel of key stakeholders, families, community partners, and state and federal agencies to develop a framework and implementation plan for promoting health and well-being for children and adolescents. Federal agencies should also include child health impact statements in their annual plans, and state agencies should implement scoring of legislation based on children and family health equity. Foundations and advocacy organizations should fund and implement a long-term public awareness campaign that highlights issues of child and adolescent health and describes the importance of children and adolescents for the nation's future well-being and economic and national security. The U.S. Department of Health and Human Services should continue and accelerate investment in research on child and family health, including mothers, children, adolescents, and families.

  • Finance health care systems for all children, emphasizing prevention and health promotion. Along with reforming Medicaid and CHIP to ensure continuous coverage and services for every child and parent under age 65 who lacks other insurance, public and commercial payers should transition from predominant reliance on fee-for-service arrangements and explore payment incentives that emphasize prevention and health promotion services, team-based and cross-sector care, health equity, health outcomes, and longer return on investment. State legislatures and Medicaid programs should also adopt and enforce policies that promote equitable payment for services delivered in school-based health centers and by other school providers.

  • Strengthen community-level health promotion and disease prevention. Federal policymakers and agencies should expand funding in ways that provide greater and equitable support for children and families in need. Policymakers and agencies at all levels should invest more in school-based community health services, such as the National School Lunch and School Breakfast programs. State legislatures should mandate investment in community health from for-profit health care providers and managed care organizations.
  • Ensure co-creation and co-design of programs and structures with youth, family, and community voices and leadership. Health care systems should partner with community members and leaders from historically marginalized backgrounds to co-design policies and build programs that support a more child-, family-, and community-centered health care system, supporting quality of care improvement, patient safety, and health equity initiatives. Federal research agencies, state governments, and foundations should eliminate barriers that make it challenging for health care entities to financially compensate patients/families for their participation in efforts to improve services or programs.
  • Implement measurement and accountability to ensure equitable achievement of these goals. The Centers for Medicare & Medicaid Services, in collaboration with other federal agencies, should support the implementation of new and updated accountability measurement systems, and federal research agencies should continue to advance data resources and collection to fill key knowledge gaps and provide a source of consistent measurement and insights. Cross-agency coordination and communication needs to be improved to monitor system performance and eliminate barriers to shared accountability across child health programs. Transparent reporting protocols need to be established across the public and private sectors.
The study - undertaken by the Committee on Improving the Health and Well-being of Children and Youth through Health Care System Transformation - was sponsored by the Academic Pediatric Association, Agency for Healthcare Research and Quality, American Academy of Pediatrics, American Board of Pediatrics, Children's Hospital Association, Health Resources and Services Administration, Robert Wood Johnson Foundation, Silicon Valley Community Foundation, and the David & Lucile Packard Foundation.
The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, engineering, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.

Contact:

Hannah Fuller, Media Relations Officer
Office of News and Public Information
202-334-2138; email [email protected]

Featured Report

2024

Launching Lifelong Health by Improving Health Care for Children, Youth, and Families

Ensuring every child is on an optimal trajectory to a healthy and productive adulthood is imperative for the nation's future. Investments in children and families improves child health, but also health equity, education outcomes, workforce productivity, and cost-effectiveness in public spending. Despite advances in health care, children, especially those from historically marginalized groups, face rising rates of chronic diseases, obesity, and mental health challenges.

Launching Lifelong Health by Improving Health Care for Children, Youth, And Families presents a vision for transforming the child and adolescent health care system. This report also examines how the health care system can be better positioned to equitably address the needs of all children and families and leverage community supports. This requires transforming key components, such as health care financing, public health investment, community partnerships, and accountability strategies, to encourage team-based care delivery models and attention to and health promotion, prevention, and root causes of health disparities.

Read Full Description

Recent News

Board on Science Education Celebrates 20 Years

Philanthropy Added to Group of Government, University, and Industry Leaders

Myopia: An Increasingly Common Disease

Ensuring Safe Operation of Long Freight Trains

  1. Load More...