Getting the incentives right for children.
OBJECTIVE
One way to improve the functioning of the American child healthcare system is through the design of incentives. Objective: to examine what we know and need to know about designing incentives to encourage the production of high-quality care both for healthy children and for children with serious illnesses.


CONCLUSIONS
For healthy children, incentives should encourage the provision of preventive services, including services that encourage healthy behavior. For children with serious illnesses, incentives should reduce risk selection, promote collaborative systems of care, and ensure access to appropriate specialty services. Research findings needed for incentive design includes information on the actual working of existing incentive mechanisms as well as information about risk adjustment, mixed payment system, carve-outs, and other mechanisms to reduce risk selection; options for defining service scope that encourage collaboration; and information about the ways in which quality measurement interacts with payment incentives.
Glied
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Division of Health Policy and Management, Columbia School of Public Health, New York, NY 10032, USA.
D002204:Capitation Fee; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002908:Chronic Disease; D005544:Forecasting; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008329:Managed Care Programs / Q000191:economics* / Q000458:organization & administration / Q000592:standards; D011314:Preventive Health Services / Q000592:standards; D011785:Quality Assurance, Health Care / Q000191:economics*; D012052:Reimbursement, Incentive / Q000458:organization & administration*; D020379:Risk Adjustment; D014481:United States