March 4, 2009
On March 4, 2009, the House Executive Committee passed HB 2343, a bill introduced by Representative Susana Mendoza (D-Chicago) to provide more equitable reimbursement for pediatric specialists who treat children covered by All Kids. The committee’s action clears the way for the full House to consider the bill.
At the hearing, committee members heard testimony from Dr. Daniel Johnson, MD of Comer Children’s Hospital in Chicago. Dr. Johnson’s full testimony follows.
TESTIMONY BEFORE THE HOUSE EXECUTIVE COMMITTEE
March 4, 2009
DANIEL JOHNSON, MD
ASSOCIATE CHAIR FOR CLINICAL SERVICES
UNIVERSITY OF CHICAGO/COMER CHILDREN’S HOSPITAL
My name is Dr. Daniel Johnson. I am the Associate Chair for Clinical Services in the Department of Pediatrics at the University of Chicago and Comer Children’s Hospital and I am a specialist in pediatric infectious diseases.
As a physician who has spent over two decades treating children who experience serious and life-threatening disease, I am acutely aware of the link between access to care and adequate funding for pediatric specialty services.
Our country, and Illinois, have focused a great deal on improving access for children who need primary care. This care, including routine check-ups and immunizations, is vitally important and we can all be proud of the increased access kids from all walks of life have to primary care.
However, the record concerning specialty care is not good. Children from across the state who have serious or chronic diseases frequently spend precious time searching for a specialty provider. Once found, they experience unacceptably long delays while waiting for the day of their specialty care appointment. There are large areas of Chicago and Illinois where there are no pediatric specialists. There is also a shortage of specialty hospital care for these same children. Families often get discouraged and fear their child will not get needed care.
I regularly provide care to a child living in the Champaign area who can’t locate a pediatric infectious disease specialist. I hear this same story over and over again from other specialists in our medical center. Recently, one of my colleagues, an endocrinologist treated a family that had driven more than 100 miles for treatment that is relatively routine; yet, the family couldn’t find an endocrinologist who had a timely appointment for a Medicaid patient closer to their home.
Low reimbursement rates reduce the availability of specialty care for sick kids and those with chronic diseases state-wide. These are children who have serious infectious, cardiac, surgical or neurological problems to name just a few. On average, kid’s specialists in our institutions are reimbursed at 34 cents on each dollar it costs us to actually provide the care.
Pediatric specialists from Cook County and across the state are stretched to the breaking point. Inadequate reimbursement discourages new pediatric specialists from going into practice, creating a shortage in available providers and appointments. As waits to be seen rise, the consequences for children with chronic or serious diseases rise and so too does the cost of care as they now must seek emergency care and hospital care—options that are much more expensive then office-based care.
We deeply appreciative the efforts that have been made to improve health care for children in Illinois but our State must take the next critical step: increasing reimbursement for essential pediatric specialty care.
On behalf of the children of Illinois, and the families who are trying to take care of their children, I ask you to take action now to stave off this looming healthcare crisis.
