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April 20, 2018

Cognitive, affective, and behavioral health (CAB) conditions are among the costliest and fastest growing in the United States. An array of interventions is demonstrated to be effective in preventing or mitigating these conditions and offers the possibility of lower costs and improved lifelong health. These effective interventions have not been widely integrated into health care, and current health care reform efforts have spurred limited additional uptake. Redesigning incentives to maximize life course CAB health is critical to reducing health costs and improving population health. Future health care reform efforts will need to redesign incentives by developing quality measures of CAB developmental outcomes for accountability, creating payment methodologies based on the expected value of changes in these outcomes, and ensuring sufficient reimbursement. These three changes would allow for timely incentives for effectively promoting life course CAB health and potentially reducing future health system spending. Health care reforms will also need to engage other sectors that contribute to and help optimize CAB health, including child care and education.