Stories about: Health legislation & reform

How Boston Children’s reduces radiation exposure

The medical journal The Lancet recently released a study that reports that children who get multiple computed tomography (CT) scans are at slightly increased risk for brain cancer and leukemia.

While the news may alarm parents, it’s something Boston Children’s Hospital has been aware of for some time. In fact, Boston Children’s has for years been at the forefront of a movement to reduce the levels of radiation exposure to young patients.

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Boston Children’s joins with Harvard Medical School to transform primary care

Those of us who do primary care often feel like Rodney Dangerfield: we get no respect. Compared to the specialists, our job is thought of as, well, lowly and ordinary.

But that’s changing—and Children’s Hospital Boston is leading the way. The primary care departments of Children’s, Children’s Hospital Primary Care Center (CHPCC) and Martha Eliot Health Center (MEHC), have been chosen by Harvard Medical School to take part in its Center for Primary Care’s Academic Innovation Collaborative. They have been awarded $900,000 over two years, to be matched by the hospital, to work with the Collaborative to transform primary care delivery and education.

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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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Children’s legal eagles

As an attorney, Kristin Small, Esq., specializes in cases where the legal and health care needs of her clients cross paths. She recently worked with the parents of a 5-year-old child with autism.

The father had lost his job and the mother couldn’t work because of the time she needed to devote to her son’s care. Though the Social Security Administration (SSA) agreed that their son qualified for benefits medically, the family was deemed ineligible because they had “too many resources.” With both parents out of work and no means of income, legal counsel was the last option they thought was available to them.

Their pediatrician referred them to Small, a staff attorney for the Medical Legal Partnership | Boston (MLP) and liaison to Children’s for the newest MLP site in the Children’s Hospital Primary Care Center (CHPCC). Providing care for more than 13,000 children—65 percent of whom are covered by Medicaid—the CHPCC is well suited to host the MLP at CHB. “Our medical and social work staff already spend a lot of time advocating for our patients,” says Joanne Cox, MD, medical director for the CHPCC. “They’re writing letters to utility companies, helping families access food stamps and communicating with landlords about poor housing conditions.” Chronic illnesses such as asthma, cerebral palsy and diabetes are often exacerbated by environmental factors like lack of food, housing, education and employment. A child my be falling behind in school due to chronic illness, or a family may be forced to choose between medicine and food. By teaming with the MLP, the CHPCC can now offer their patients direct access to legal information and support to help them make sure their needs are being met.

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