Author: James Mandell, MD, CEO

My thoughts on federal health reform

MandellEarlier this week, we shared on our Thrive blog some comments about the new health reform legislation by Judy Palfrey, MD, president of the American Academy of Pediatrics and a long-time pediatrician at Children’s Hospital Boston.

Reactions to the post were both positive and negative when it was shared on our Facebook page, with some people wondering why we would share our “political” views. First let me say that I think it’s important to distinguish views about political candidates and political parties from “policy” views about things that are good or bad for children and the providers who care for them. I also think it’s important to recognize and give voice to the incredible breadth of knowledge and expertise we have here at Children’s. Dr. Palfrey has spent her entire career working on child advocacy issues and is nationally recognized on the subject, and we’re fortunate to be able to share her knowledgeable voice on our blog.

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Globe article on the cost of care at Children's

MandellA Boston Globe article this morning brought the cost of care here at Children’s Hospital Boston into question, saying, among other things, that “Children’s charges the highest fees for both outpatient and inpatient care.” It’s based on data by Harvard Pilgrim Health Care (HPHC) that we don’t feel accurately reflects the care that we provide.

While the writer, Liz Kowalczyk, did say that because about 30 percent of our patients are on Medicaid, we have to “make up the lost revenue from private insurers,” I don’t think she went far enough in explaining why our costs tend to be higher than other hospitals in the state.

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An unprecedented partnership with the state’s largest health plans


James Mandell, MD

As Washington works toward national health reform, we’re pleased to announce that Children’s has established an unprecedented partnership with the state’s largest health plans to help accelerate the transformation of the pediatric care delivery system by expanding innovative approaches and models of care. Working with Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan, Children’s and its physicians volunteered to cut its fiscal year 2010 payment rates. A portion of these savings will be targeted to support such efforts as:

  • SCAMPs (Standardized Clinical Assessment and Management Plans) – a revolutionary way to provide clinicians with immediate feedback on the success of their treatments. It uses the best evidence to guide testing and treatment decisions, and the best judgment of practicing physicians to standardize care plans for clinical situations. Most important, the approach allows clinicians to continually refine treatment approaches to deliver the best outcome.
  • Integrated Care Models – a crucial element of the primary care model known as the family-centered Medical Home, in which a primary care provider works in partnership with families to coordinate care for their children. The fund will expand and accelerate implementation pilots to more efficiently coordinate care of chronically ill patients with diabetes, asthma and other conditions.
  • Next Generation Information Technology – are vital to our role as innovators of models of care and the patient experience. In addition to the technology behind SCAMPs, Children’s developed “MyChildren’s,” the first pediatric patient and family controlled medical records fed by both pediatric and specialist health care providers.
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How health care reform can benefit children and adolescents

image1-150x150The debates around federal health reform continue to involve complex decisions, and many of them originate from an “adult medicine” perspective.

Both the American Academy of Pediatrics (AAP) and the National Association of Children’s Hospitals have taken leadership roles to assure that child health needs are appropriately recognized in the final legislation. Judy Palfrey, MD, Children’s Hospital Boston’s longtime chief of General Pediatrics, has been an eloquent and engaged voice for pediatric care and has spent a great deal of time in Washington recently in her role as president-elect of the AAP. Her recent article in The New England Journal of Medicine lays out some of the critical issues we have been watching and working as a child-health community.

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