by Sean Ruck
, Contributing Editor | October 05, 2018
From the October 2018 issue of HealthCare Business News magazine
I want to be clear that this is speaking from my perspective. I think what’s challenging about pediatric and reimbursement these days is that Medicaid is federally funded, but state-regulated. So one state may be reimbursing hospitals in a reasonable manner for their Medicaid populations and another state may be really difficult. That really varies. In the last few years, all the workarounds and how things are reimbursed make it challenging. I think the big challenge for children’s healthcare, as I mentioned earlier, is getting the attention of legislators. And the way Medicaid is regulated right now is a little challenging.
HCB News: With hospitals being a place for ill individuals and children undergoing treatment sometimes having compromised immune systems, is there a concern with the growth of non-vaccinated children arriving for treatment?
As a pediatric healthcare provider, I would say we absolutely have a concern about that and that is a little bit of an issue specifically in this community. The concern is partly ensuring that we’re keeping everyone safe within our hospital. That’s why we have a lot of different screenings in place to make sure we understand who’s coming in through the door. Moreover, we know from the science that vaccinations can prevent what can be deadly diseases. So it’s not just about preventing the spread of disease within a community, but also about the individual child avoiding a disease that could cause long-term complications or even death. For instance, there was an outbreak of mumps in this community a couple of years ago.
HCB News: What are your predictions on how child-focused healthcare should change and how it might change over the next five to 10 years?
I think in pediatric healthcare we have the advantage of a relatively small community, compared to the rest of healthcare. It allows us to come together and learn best practices from each other, do focused research on children, and gain knowledge about patient safety and outcomes in a much more nimble way. There’s an international association called the Children’s Hospital Association. In the past 10 years or so it’s become much more comprehensive, and this group has developed what they call “solutions for patient safety.” They’re bringing experts from children’s hospitals around the world and pooling knowledge and resources around understanding what the safety risks are for children in hospitals and clinics, what the pediatric healthcare outcomes are that we believe we want to make an impact on but haven’t yet, and working toward comprehensive solutions. I see pediatric healthcare really setting a high bar in relation to the rest of healthcare as to how we can come together and benefit the patients we serve.