OBJECTIVE: Current pediatric well-child care (WCC) may be inefficient and inadequate with respect to primary care physicians' abilities to deliver prescribed preventive and developmental services. New Internet-related technologies may improve the efficiency and effectiveness of WCC. This article examines the potential resource cost implications associated with a change in the delivery model of WCC in a capitated, integrated managed care system. STUDY DESIGN: Decision analyses and Monte Carlo simulations were used to estimate the variation in resource costs between the current WCC model and a high-performance WCC model, stratifying by age, risk level, and the proportion of pediatric members that may not seek WCC. METHODS: Demographic and health care utilization data associated with 14,910 pediatric enrollees, ages newborn to 5 years, enrolled at Kaiser Permanente Colorado were used to simulate the change in costs attributable to a change in the model of WCC. RESULTS: Simulation models and sensitivity analyses suggest that the implementation of the high-performance WCC model is likely to be relatively resource cost neutral in a managed care system. CONCLUSIONS: Preliminary findings suggest that implementation of innovative changes in WCC may allow for efficient reallocation of resources to higher-risk children in a relatively cost neutral manner. However, innovative changes that involve the use of unreimbursed non-face-to-face encounters and nonphysician health care professionals may present challenges with respect to implementation of a new model of WCC in a fee-for-service environment.
OBJECTIVE: Current pediatric well-child care (WCC) may be inefficient and inadequate with respect to primary care physicians' abilities to deliver prescribed preventive and developmental services. New Internet-related technologies may improve the efficiency and effectiveness of WCC. This article examines the potential resource cost implications associated with a change in the delivery model of WCC in a capitated, integrated managed care system. STUDY DESIGN: Decision analyses and Monte Carlo simulations were used to estimate the variation in resource costs between the current WCC model and a high-performance WCC model, stratifying by age, risk level, and the proportion of pediatric members that may not seek WCC. METHODS: Demographic and health care utilization data associated with 14,910 pediatric enrollees, ages newborn to 5 years, enrolled at Kaiser Permanente Colorado were used to simulate the change in costs attributable to a change in the model of WCC. RESULTS: Simulation models and sensitivity analyses suggest that the implementation of the high-performance WCC model is likely to be relatively resource cost neutral in a managed care system. CONCLUSIONS: Preliminary findings suggest that implementation of innovative changes in WCC may allow for efficient reallocation of resources to higher-risk children in a relatively cost neutral manner. However, innovative changes that involve the use of unreimbursed non-face-to-face encounters and nonphysician health care professionals may present challenges with respect to implementation of a new model of WCC in a fee-for-service environment.
Authors: Stephen J Blumberg; Elizabeth M Welch; Sadeq R Chowdhury; Heidi L Upchurch; Eloise K Parker; Benjamin J Skalland Journal: Vital Health Stat 1 Date: 2008-12
Authors: Debra P Ritzwoller; Jennifer L Ellis; Eli J Korner; Cynthia L Hartsfield; Alesia Sadosky Journal: Curr Med Res Opin Date: 2009-06 Impact factor: 2.580