Children and families deserve a healthcare system that is tailored to their specific needs, fostering lifelong health and well-being. However, the current primary care system is failing too many children, particularly those from Black, Indigenous, Latino, and other communities of color. To address these critical gaps, the concept of an Accelerating Primary Care Transformation Program is gaining momentum, aiming to revolutionize how primary care is delivered, especially to our youngest populations.
The Accelerating Child Health Transformation (ACHT) initiative, spearheaded by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation, serves as a vital example of this movement. ACHT is dedicated to speeding up the implementation of essential elements that promote family-centered pediatric practices. This program emphasizes three fundamental strategies, identified through a comprehensive national review of successful approaches, which are crucial for any accelerating primary care transformation program focused on child health:
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Implementing Anti-Racist Practices and Policies: A core component is the adoption of anti-racist practices and policies within primary care settings. This is essential to dismantle systemic inequities and advance health equity for all children. This involves actively addressing biases within healthcare delivery and creating a system that is just and fair for every child, regardless of their racial or ethnic background.
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Building Equitable Partnerships with Families: Effective primary care transformation necessitates the co-creation of equitable partnerships between healthcare providers, patients, and their families. This approach ensures that families are not just recipients of care but are active participants in decision-making and care planning. By valuing family expertise and perspectives, programs can become more responsive and effective.
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Identifying Family Strengths and Addressing Social Needs: A holistic approach to primary care recognizes that health is influenced by a wide range of social factors. An accelerating primary care transformation program must prioritize identifying family strengths and addressing health-related social needs (HRSN) to build resilience and improve health outcomes. This includes screening for and connecting families with resources to address issues such as food insecurity, housing instability, and lack of transportation.
For these strategies to be widely adopted and impactful, changes are needed not only within individual primary care practices but also at the systemic level. Payment structures and accountability measures must evolve to support these enhanced, comprehensive approaches to care. Innovative payment models are particularly critical within Medicaid, which provides healthcare coverage to over 45% of children and youth in the United States, a significant proportion of whom come from historically marginalized communities. Medicaid’s role in financing primary care makes it a key lever for driving meaningful transformation.
From 2021 to 2023, ACHT convened leading child health experts, pediatric primary care providers, and family engagement advocates across the nation. This collaborative effort was designed to explore concrete opportunities to strengthen child health care, accelerate the adoption of anti-racist practices, and champion family-driven approaches that effectively address health-related social needs. These dialogues and explorations are invaluable for informing the direction of accelerating primary care transformation programs nationwide.
Currently, CHCS and its partners are actively engaging with leaders in the child health field to gain deeper insights into critical questions:
- How can we best support primary care providers and family engagement leaders in enhancing the quality of care and addressing health-related social needs while upholding dignity, promoting racial equity, and ensuring meaningful family involvement?
- What specific Medicaid payment and accountability mechanisms — including the development of alternative payment models and strategic managed care contracting — can state policymakers effectively utilize to encourage practice-level changes that demonstrably reduce racial and ethnic health disparities?
The Child Health Transformation Resource Center, developed by CHCS, plays a crucial role in disseminating lessons learned from the ACHT Learning Community and other pioneering initiatives. This comprehensive online resource serves as a valuable compendium, offering reports, practical tools, and other resources from ACHT and organizations working at the forefront of child health transformation. It is designed to equip healthcare providers, community-based partners, family and patient engagement leaders, policymakers, and other stakeholders with the actionable knowledge and resources they need to transform pediatric primary care. By promoting anti-racist, family-driven, and holistic models of care, these resources are essential for anyone involved in an accelerating primary care transformation program focused on children.
