This Viewpoint argues that value-based care (VBC) frameworks were designed for adults and are poorly suited to children enrolled in Medicaid managed care organizations (MCOs), calling for foundational reforms.
The authors identify a structural gap: current VBC models lack pediatric-specific quality metrics, risk adjustment, and incentive structures necessary to serve children in Medicaid MCOs.
As a Viewpoint piece, the paper presents expert opinion without original data, systematic review, or quantitative outcomes; specific reform proposals are not empirically tested.
Clinicians and policymakers working with pediatric Medicaid populations should advocate for child-specific quality measures and risk models within VBC contracts, as existing adult-oriented frameworks may underserve children's health needs.
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