Transforming Pediatrics for Early Childhood: Illustrative Financing and Payment Mechanisms
Explore examples of financing and payment approaches that states and communities are using, or could use, to sustain early childhood developmental services.
This resource highlights strategies that states, Tribes, and communities use to operationalize and finance the Early Childhood Development Continuum of Care, which includes services related to promotion and prevention, surveillance and screening, care coordination and linkage, and intervention.
Drawing on examples from across the country, this resource examines how programs have structured, funded, and scaled components of the continuum, along with their reported results. It also examines broader health care financing mechanisms that currently support, or could be leveraged to support, multiple aspects of the continuum.
What's Included
The resource features payment strategies, examples, and implementation insights across the four components of the Early Childhood Development Continuum of Care:
- Promotion and Prevention: Develop payment for staff member(s) or team-based models in pediatric primary care settings that focus on early childhood promotion and prevention activities.
- Surveillance and Screening: Invest in broad-based surveillance and ensure that screenings are billable at points of care.
- Care Coordination and Linkage: Finance the infrastructure needed to coordinate care – including standardized care plans, referral tracking, and family navigation – to meaningfully connect children with identified needs to services.
- Intervention: Establish payment for evidence-based intervention services, such as embedded coaching, preventive behavioral/mental health visits, and consultation and training for pediatric primary care teams.
It also includes cross-cutting financing strategies that can support multiple components of the continuum, with examples of how states combine funding sources rather than relying on a single mechanism. The strategies highlight approaches and potential next steps for community reinvestment, excise tax revenue, settlement funds, Medicaid procurement, CHIP Health Services Initiatives, Medicaid coverage and service-based payments, and statewide early childhood strategic assessments.
