Beyond Boundaries
Enabling Better Health for All Children
Providing children with access to high quality care is an important first step toward better health; it’s one way we can gauge a child’s current health status then, identify what is needed to improve it. Using our inclusive definition of health, this aspect of our work also helps us understand the changes necessary to improve communities so that all children may forge a path of lifelong health and well-being in its fullest meaning. Our transformational approach to redefining children’s health and creating the healthiest generations of children requires active and well-coordinated partnerships within communities and at the highest levels of policymaking.
Proving Its Value: Delaware Children’s Health Network
The Delaware Children’s Health Network (DCHN) has increased access to high quality primary care for more than half of Delaware’s children. In 2020, the DCHN was able to complete its first value-based reimbursement contract with payers as a clinically integrated network (CIN). In addition, 2020 saw the fulfillment of another DCHN goal to increase access for Delaware’s most vulnerable populations when it was authorized to serve as a Medicaid Accountable Care Organization (ACO) by the Delaware Department of Health & Social Services. Both accomplishments serve to formally recognize the DCHN and its providers (a total of 32 non-Nemours and Nemours practices) as prepared to provide high value care that improves outcomes for Delaware’s children while controlling the cost of care.
Value-based care seeks to improve the health of the population that’s being measured — and for Nemours, that population includes all children.
Together is Better: Improving Metrics & Reducing Disparities
Families across the U.S. were compelled to put off routine care during 2020. Remarkably, Nemours saw an increase in well-child visits and immunization rates for Pneumococcal-23 and influenza (compared to 2019) among its pediatric populations in the Delaware Valley. Perhaps even more extraordinary, these increases extended to our Black/African American pediatric population where the greatest disparity typically exists. These two critical metrics of children’s overall health and well-being are also key quality outcomes measurements for Nemours Value-Based Services Organization (VBSO) and the DCHN. Along with payer flexibility and emergency rules, integrated efforts among DCHN providers and the Nemours VBSO team to increase well-child and immunization rates included:
- Care coordinators’ communication with families via phone calls, 80,000 text messages and 82,000 emails
- Utilizing telehealth for allowable well-child visits (Telewell)
- Creating safe, outdoor spaces for drive-thru immunizations (Immunization Stations)
- Pairing the use of Immunization Station exams with Telewell visits, allowing for reviews of growth charts, visit findings, blood draws and flagging follow-ups for primary care
Learn more about how Nemours increased access to preventive care during the pandemic.
Notes from the Field
As part of a two-year project exploring how healthcare organizations acting as integrators can join, catalyze and sustain cross-sector networks working on shared population health goals, Nemours Children’s Health released an issue brief, “Preliminary Findings on the Role of Health Care in Multi-Sector Networks for Population Health: Notes from the Field.”
The issue brief flows from the first wave of work: a literature scan and interviews with 40 national experts with insights related to integrative roles and functions within multi-sector population health networks, as well as the ways healthcare is involved in carrying out these roles and functions in support of networks’ shared goals. Themes captured in the brief are presented as:
- Findings: What early lessons can be learned from the 40 interviews with field leaders?
- Focus on Success: What communities can we look to for work that illustrates findings presented in this brief?
- Recommendations: What is the import of these learnings for the field?
Data help reveal areas that are most in need of reform, while data indicators help track progress toward equity. Nemours’ reference guide helps states and communities identify, select and track indicators to advance efforts. Download the Nemours-authored reference guide.
Transforming Child Health Practices for Good
The Nemours National Office Practice & Prevention team continues to provide leadership, guidance, tools, and technical assistance on efforts that support the health, well-being and healthy development of all children. This team is helping spread, scale and sustain evidence-based population health strategies in 34 states across the U.S., through the following projects:
Securing a Prosperous Future
Last November, nearly 400 leaders and organizations across the U.S. joined forces to call on then-President-elect Biden and Vice President-elect Harris to establish cohesive national leadership for children and youth. This call for a federal strategy, led by Nemours Children’s Health, Mental Health America, First Focus on Children, The Education Redesign Lab at Harvard Graduate School of Education, and the Forum for Youth Investment, is a response to the confluence of the pandemic, longstanding racial injustice, and economic challenges that are creating a critical inflection point for our nation’s future — which will be driven by today’s children. To ensure optimal health, well- being and development for all children and youth, we must reimagine systems, allocate appropriate funds, and elevate national leadership on behalf of children and youth.
Nemours and its partners believe a federal structure would ensure that leaders at every level prioritize and coordinate children’s needs, offering the services, resources and support that will allow them — and our nation — to flourish. Learn more at Nemours.org/WHOffice4Kids.
Leading up to November, Nemours and partners held two virtual convenings with leading experts, released two issues briefs and developed a sign-on letter that now has more than 400 signatures.
Building Back Better: Federal Leadership for Children & Youth (full briefing)