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Where Can Specialty Pediatrics Fit in Value-Based Care Conversations?

In the latest episode of Healthcare Strategies, Larry Epstein discusses the challenges pediatric specialists face when fitting into value-based care arrangements.

Pediatric specialist value-based care

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By Emily Sokol, MPH

- Pediatrics is often left out of value-based care conversations, particularly specialty pediatrics. In the most recent episode of Healthcare Strategies, an Xtelligent Healthcare Media podcast, Larry Epstein, CEO of Pediatric Urology Associates, discussed just what that means for his organization and others like his.

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The private, pediatric, sub-specialty practice in New York currently operates predominantly in fee-for-service contracts but is working on gathering quality measures and care services that push the organization toward value-based care in the future.

“There isn’t as much bang for the buck and financial risk and reward in pediatrics as there would be in adult care,” Epstein noted on the podcast. “And that’s because there isn’t as much chronic care management with pediatrics.”

Currently, there are limited financial risk models associated with pediatric outcomes. Most arrangements target chronic disease outcomes which largely affect the adult population.

Private pediatric groups also face a lack of affiliation with larger children’s hospitals. Historically, Epstein explained, these organizations have been at the forefront of integrated care.

“The challenge is that most pediatric practices are still not aligned with large healthcare systems unless they align themselves financially, operationally, through merger and acquisitions, with children’s hospitals throughout the country,” he elaborated.

But Epstein remains optimistic. Gathering data on preventive measures to monitor the impact on patient outcomes long term is the first step in solving the problem. These measures should include metrics like vaccination rates, weight management, and behavioral health.

Information systems that can connect this data would allow smaller practices to share information on patient health outcomes and help build the evidence base for pediatric value-based care.

“We need to start showing rewards for doing that extra work and reporting out on it,” Epstein concluded. “It’s reallocating the resources so the communities can start rebuilding their community-based systems and engaging the pediatricians and pediatric service community to deliver those outcomes in a more direct and risk-associated way.”

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