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How Provider Relationships Shape VBC Pediatric Quality Measures

By building a robust payer-provider relationship, payers can better ascertain the right quality measures to mobilize pediatric quality measures in value-based care.

If value-based care in pediatric healthcare truly is the future of value-based care, payers need to leverage strong provider relationships to establish effective pediatric quality measures in order to improve their pediatric value-based care performance, Horizon’s executive vice president for healthcare management and transformation Allen Karp illuminated.

Over six in ten adults across 25 states have reported having at least one adverse childhood experience (ACE), according to the Center for Disease Control. Nearly one in six adults had experienced four or more ACEs.

These environmental factors have the potential to orient the child toward poor health decisions for the rest of their life, leading to conditions such as heart disease and depression. ACEs also end up costing billions of dollars in healthcare spending.

Horizon, a Blue Cross Blue Shield company located in New Jersey, responded to these statistics with a new pediatric value-based care model. As a result, over the past five years, the company has seen an influx of providers taking on more risk, including downside risk.

Read more at Healthpayer Intelligence.