Researchers Investigate Ways to Finance Children's Health Now to Optimize Future Health Status

Background paper and meeting on longitudinal funding options for children's health care

Investigators at the University of California, Los Angeles, Center for Healthier Children and Families convened a meeting of experts to discuss how innovative financing strategies from other industries could be adapted to promote optimal investment in children's health.

The meeting, entitled "Longitudinal Financing Options for Children's Health Care," was held October 20, 1999, in Los Angeles.

Key Results

  • Some 28 individuals with expertise in public health, child development, financing and health services research attended the meeting.

  • Investigators prepared a background paper, entitled "Motivating Investment in 'Health Development' in Children's Health Care," to guide participants' discussions at the meeting.

  • Key topics of discussion included:

    • Why "investment" in the health and functioning of children can profoundly alter health status and achievement in adults.
    • Whether financing strategies that reward "longitudinal" or long-term investment in other industries could be adapted to promote optimal investment in children's health.
    • What incentives are needed for managed care organizations, public institutions that serve children (including schools) and communities, more generally, to invest in the optimal health development of children.

Key Findings

  • In a report to the Robert Wood Johnson Foundation (RWJF), the investigators reported a number of key findings, which were derived from a literature review, the background paper and meeting discussions:

    • There is a fundamental conflict between the social objectives of enhancing development and, ultimately, adult productivity and the current financial incentives in the health care sector.
    • Financial incentives to reduce risk factors and enhance protective factors in early childhood will require both longitudinal transfers and cross-sector transfers of resources or funds.
    • The next stage should involve a "mapping" of what could be achieved from greater investment in child health development through a set of examples. These specific areas could be developed in terms of the incentives involved—and then the relevant possibilities for financing solutions could be evaluated in some detail.
    • Investigators published a paper, entitled "The Health Development Organization: An Organizational Approach to Achieving Child Health Development," in the Milbank Quarterly [78(3): 447–497, 2000].
      • The paper proposes the creation of a new model for delivering health care to children: the "health development organization" (HDO). The HDO combines the health maintenance functions of the HMO with health-promotion services designed to optimize future health status.

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