Stories about: cost of children’s care

Finding unique value in the medical home model

Ari Brown, MD, FAAP

By Ari Brown, MD, FAAP. Dr. Brown is a pediatrician, author of the Baby 411 book series and has offered her expertise to several media outlets including the Today show, CNN and the Wall Street Journal. Dr. Brown completed her residency at Children’s Hospital Boston in 1995 and will be joining her peers at an upcoming alumni reception at the Institute of Contemporary Arts on October 15. For more information visit, Children’s event website.

You are as old as you feel, right? Most days, I feel like I’m still a kid—probably because I hang out with kids all day long. But the other day, I received an invitation to my 20-year medical school reunion. Admittedly, I felt just a little old…and a bit reflective.

The last time I saw many of my med school classmates was when I was 26, and heading off to my pediatrics residency at Children’s Hospital Boston. So much has happened since then. Marriage. Kids. Career. But unlike some of my peers, I wouldn’t change a thing.

I’ve loved pediatrics for twenty years. I am truly happy going to work every day. I have a special relationship with my patients and their families—a relationship that they will never have with the practitioner working in the minute clinic around the corner. I am the one who examines my patients when they are first born. I perform the well child visits, encourage breastfeeding, answer the worried parent phone calls, identify developmental delays, offer parenting advice, and diagnose the colds, flus, ear infections and occasionally things a bit more serious. And I love every minute of it (okay, almost every minute of it). I love it because I can help future generations develop healthy lifestyles and I genuinely enjoy watching my patients grow up.

But, the current trends in healthcare—particularly in pediatrics—are troubling to me. More parents are heading to that minute clinic around the corner to get their child a quick Strep test after school and work, choosing convenience over quality and continuity of a medical home. Are pediatricians going to become the next Borders or Netflix? Are we being shoved out of the marketplace because we haven’t kept up with consumer demand?

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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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This week on Thrive: March 15 – 19

Here’s a quick look at what Thrive was up to last week.

Children’s Michael Agus, MD kept us updated on his relief work in Haiti. There’s a better genetic test for autism. Children’s CEO, James Mandell, MD, discusses the cost of children’s care. Children’s is featured in two National Geographic documentaries – one on the Shang Dynasty and the other on rare medical conditions. A newborn’s hearing screening should not be ignored. Thrive blogger, Melissa, reports on disaster relief simulation training. Are iPhone apps okay for toddlers? How can kids respond to email chain letters?

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