The National Association of Children’s Hospitals is weighing in on the health care reform debate, claiming children covered by Medicaid are often being denied the critical care they need.
Doctor F. Sessions Cole, Chief Medical Officer at St. Louis Children’s Hospital, says discussion of pediatric children’s services seems to have been forgotten.
“There is a shortage of pediatric specialty providers – physicians and pediatric sub-specialist surgeons – in the United States, said Doctor Cole in an interview with the Missourinet. “And there’s really no discussion, right now, about how to improve access of children, both in cities and in rural areas, to required pediatric specialty services.”
Medicaid, MOHealthNet as it is known in Missouri, provides medical services to children in low-income families. But physicians providing services are not adequately compensated by the government.
“Medicaid reimbursement for physicians of pediatric services – pediatric doctors – is inadequate,” said Doctor Cole. “The easiest way to understand how inadequate it is is to understand that a physician who is taking care of exclusively Medicaid patients will not be able to cover her or his operating costs.”
The Association would like to see the reimbursement rates increased.
“I would propose that physicians who care for children – pediatric specialists – receive reimbursement for their services that is equivalent to the reimbursement that is given to doctors who provide medical services for adults,” said the doctor. “Right now, Missouri Medicaid pays less than two-thirds – for pediatric services – of what it would pay to an adult doctor to give a comparable service.”
Since the reimbursements paid by Medicaid do not cover the cost of providing care, many community providers either limit the number of or do not serve Medicaid patients.