Pediatric Complex Home Care – an individual category. Because Medicare policy should not define care for all.
Protect our most vulnerable citizens. Support a Pediatric Complex Care designation bill.
Our goal is to create a designation that recognizes children with medical complexities as a special population and addresses the unique characteristics of organizations that care for them. Because children with medical complexities vary greatly from adults on Medicare, and legislation should recognize these differences by creating healthcare models that provide the right interventions and the right support.
Applying resources appropriately benefits patient care
Advance Care for Children
Allows providers to focus on clinical skills, technical abilities and patient-focused service. It rewards innovation by advancing new service lines, new therapies and new equipment at home.
It will also allow lawmakers to tailor programs for providers of complex and comprehensive services, ensuring that our focus stays on high-quality, clinically excellent, safe patient care in the most cost effective environment.
Reduce the Total Cost of Care
Creating a designation opens the door to consider innovative payment structures, moving away from traditional and siloed fee for service models.
A designation will allow for reimbursement based on quality measures and patient outcomes across all aspects of a child’s medically complex home care services.
Reduce the Administrative Burden
Each service has distinct regulatory requirements, creating an immense burden for the home care provider, the prescriber and governmental agencies.
Ensuring compliance with multiple sets of regulations takes resources away from what matters most: advancing care for our complex pediatric population.
Diagnosed with infantile Pompe Disease at four months, he requires integrated services to thrive at home with his family.
Weekly infusion nursing visits for an enzyme replacement therapy (ERT) treatment, equipment and supplies, and support from a respiratory therapist ensure Leo is continuing to grow and develop at home with his tracheostomy and ventilator.
His needs, and the needs of other medically complex children, are best met by a pediatric care team that specializes in the unique needs of children and can accommodate for growth, development and physical conditions that often make it more challenging to provide care.
Each of these services (infusion therapy, pharmacy and respiratory therapy) work together to ensure clinically excellent, safe and cost-effective care for Leo.
Legislation needs to be updated to stop looking at each service with a separate lens and instead recognize the value for this population in a comprehensive care model.
Pediatric home care is modern medicine.
Thirty years ago, home care for medically complex children wasn’t an option. Today, we have the technology, equipment, and clinicians to best comprehensive care for complex pediatric patients, but we can’t stop there.
We must continue to evolve health care legislation to ensure resources are put toward providing the best comprehensive and integrated care for patients. We have the opportunity to advance care while reducing overall cost.