Author: Sandra L. Fenwick, President and CEO

Thank you for making Boston Children’s #1

The 2017-18 U.S. News & World Report “Best Children’s Hospitals” rankings were released this morning, and Boston Children’s Hospital has been named the #1 children’s hospital in the nation.

The U.S. News rankings are about more than just reputation. They’re based on four key elements — reputation, patient outcomes, patient safety and care-related factors such as the amount of nurse staffing and the breadth of patient services. They rely most heavily on outcomes — in other words, were we able to make a difference?

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Children’s and Blue Cross Blue Shield usher in new age of quality-based benchmarks in pediatrics

Sandra Fenwick, president and COO

I’ve worked at Children’s Hospital Boston for more than a decade, and I’m still inspired every day by the hope and strength I see on the faces of our patients and their families. As Children’s navigates a challenging and evolving health care landscape, I draw on that inspiration and determination, especially when many in our industry seem to imply that cost is the only measure of a hospital’s worth.

At Children’s, our worth—our value—is so much more than just dollars and cents. It means being treated by pediatric experts—doctors, nurses and support staff—who understand that children are not small adults and their care needs to reflect that fact. It’s a commitment to care and innovation that produces programs like our Community Asthma Initiative, which helps children with asthma have fewer attacks so they miss less school and their parents miss fewer days of work.

And it’s about a commitment to constantly improving the quality of the care we deliver. To that end, I am pleased to announce that we have signed an innovative new contract with the state’s largest health insurance provider, Blue Cross Blue Shield of Massachusetts (BCBSMA).

This agreement, known as an Alternative Quality Contract (AQC), calls for us to reach quality targets based on national pediatric quality benchmarks—the first such contract in the country—and keeps the contract value well below medical inflation

The AQC has specific quality measures in the areas of primary care (prevention and treatment), effectiveness of treatment for patients with certain conditions or needs (cystic fibrosis, dialysis or general surgery needs) and safety (central line infections). In addition, we have agreed to accept a 0 percent rate increase in the first year and an average 1.5 percent annual increase over the three years of the contract.

Since 2009, Children’s has taken more than $125 million out of the health care system to benefit insurers, employers and consumers

This contract is aligned with our efforts over the last three years to improve quality  while slowing the rising cost of care delivery. Since 2009, Children’s has taken more than $125 million out of the health care system to benefit insurers, employers and consumers. We have reduced insurers’ rates and prices, become more efficient and have innovated new ways to deliver care that improve quality while lowering costs. In addition, we have moved care to lower-cost settings within the hospital and to our less expensive suburban satellites and community hospital partners, and have improved care integration between primary care physicians and hospital subspecialists.

As far as I’m concerned, the greatest indication of Children’s value is the trust of the parents who place more than 170,000 children in our care each year. Whether they come to us from around the block, or the other side of the world, Children’s takes great pride in knowing that every patient who comes through our doors will receive the same level of world-class care that has made Children’s a leader in pediatrics for more than 140 years.

For more on the Blue Cross Blue Shield deal, read Sandra Fenwick’s interview with WBUR.

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Globe article highlights Children's efforts to reduce cost, improve quality

Sandra Fenwick, president and COO

With controlling health care costs high on the list of public policy priorities, Children’s Hospital Boston has been a leader in reducing costs in a way that continues to improve quality. A story in yesterday’s Boston Globe highlights some of our initiatives, including the fact that we voluntarily reduced our prices and rates to private insurers and to Medicaid-managed care programs by $90 million over the last year and a half. Importantly, the article also points out the fact that pediatric care is more expensive to deliver than adult care and that Children’s costs are closely aligned with those of other pediatric-only hospitals around the country; this is a message we’ve been trying to share in discussions with the government and payers in the last several years.

The initiatives described in the article—including working closely with insurers to reduce fees for high-volume appointments and tests, developing payment structures that reward quality and innovation, and an effort to have children with recurrent headaches seen in the most effective and cost-efficient setting—are only a few of the hundreds of projects underway across the hospital. This comprehensive, multi-pronged, data-driven continuous effort  to improve quality and reduce unnecessary resource utilization has driven much of our thinking and planning in the last several years, and will continue to do so for many years to come.

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Reducing health care costs

Sandra Fenwick, president and COO
Sandra Fenwick, president and COO

If you picked up the paper earlier this week, you may have seen an article in The Boston Globe about Massachusetts Senate President Therese Murray’s call for health care providers to contribute money to a $100 million fund directed toward easing the health care cost burden on small business. Partners Healthcare committed $40 million to the fund.

We commend the Senate President for her leadership role in offering pragmatic short- and long-term solutions to complex health care issues, and for proposing a way to relieve cost pressure on small businesses.

For the past two years, Children’s has taken an ambitious series of steps that have already significantly reduced health care costs across the delivery system. This year, we’ve decreased the prices of our medical services and reduced our rates to Massachusetts health insurers by a total of $33 million. We’ll be making more price cuts and rate reductions totaling an additional $10 million in the next six months.

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