The goal of improving the nation’s health care delivery system is the focus of all, even as the continuing debate in Washington shows us that the approaches of how to achieve this are different. I was invited to lunch yesterday with HHS Secretary Kathleen Sebelius, CMS Director Donald Berwick and their staffs to discuss the issues now being debated on Capitol Hill. I was joined by leaders of the American Hospital Association, the Federation of American Hospitals, the National Association of Public Hospitals, the Catholic Health Association and the Association of American Medical Colleges. We have promised to continue our dialogue on a regular basis.
The conversation reminded me of all the positive provisions now contained in the law:
- preventing insurers from denying coverage to children with pre-existing conditions and removing annual and lifetime caps on children’s coverage
- extending authority and funding of CHIP
- starting to address access for children by reducing Medicaid payment disparities by requiring Medicaid pay at least Medicare rates for primary care physician services, including pediatric medicine, for two years
- creating opportunity for Medicaid reforms, including new payment models such as pediatric ACOs, medical homes and other innovations through the newly created Innovation Center
In addition to the advance that children’s hospitals have achieved, much work remains ahead. For example:
- Medicaid reimbursement remains 30 percent less than Medicare for the same services
- DSH must be kept in place until Medicaid payments cover the cost of care
- Access to specialty care will remain a challenge if economic incentives that support pediatric specialists are reduced or eliminated
Children’s hospitals are well positioned to be at the forefront of efforts to achieve these and other policy goals. As essential regional providers and integrated delivery systems, children’s hospitals will continue to be national leaders on improving quality of care, expanding access and providing value. We must continue to lead so that the nation’s children--who are our future--enjoy the benefits of a health care system that leads the world in cost efficiency, quality of care and compassion.