Ep 48 – Winning in Pediatric Value-Based Care, with Ginger Hines and Dr. Sheryl Morelli

What this episode covers

Former President of South Africa, Nelson Mandela, made an important observation when he said, “There can be no keener revelation of a society’s soul than the way in which it treats its children.” Our children are wholly dependent upon us, their parents, teachers, and society for their education, their safety and their health. It is with this mindset that we proclaim, high-value pediatric care is critical for winning the race to value. Our guests this week are Ginger Hines, Executive Director, Seattle Children’s Care Network and Dr. Sheryl Morelli, Medical Director for Seattle Children’s Care Network, and Clinical Professor of Pediatrics, University of Washington School of Medicine. Seattle Children’s Care Network (SCCN) is a pediatric clinically integrated network comprised of Seattle Children’s Hospital, 600 specialists in Children’s University Medical Group, and 20 primary care pediatric practices comprising more than 200 providers and 6 specialty clinics. Member practices in the CIN support the health of 50,000 pediatric lives in value-based contracts. Episode Bookmarks: 03:20 Background on Seattle Children’s Care Network (SCCN) and Seattle Children’s Hospital 04:45 Pediatric value-based care being driven by employers and how SCCN formed direct-to-employer contracts 05:30 The movement to value-based care in Washington State’s Medicaid program 06:00 How SCCN engages with physicians to build trusting relationships and a shared vision 09:00 The long-term societal benefits to investing in children’s health 10:30 Children with high BMIs that become adults with diabetes, CHF, and depression 12:00 Parents missing work to take care of unhealthy children and how employers investing in children’s health care lead to productive employees 12:40 Leveraging data and analytics in the CIN and how vaccinations and well child visits are key to disease prevention 15:00 How pediatric value-based care is different than adult value-based care 15:30 Data integration within SCCN and how the HIT infrastructure is foundation to success in population health 17:20 The validation of data accuracy as a critical success factor to building trust and supporting evidence-based quality improvement 19:30 Operational efficiencies within the CIN as a more effective way to provide actionable insights to providers 21:00 Developing consistent pediatric quality metrics and standardizing care within the CIN 24:00 Benchmarking quality performance at both the regional and national level 25:00 Recognizing the opportunity in pediatric value-based care and how you have to look for cost savings and improvements in different areas 27:30 Establishing a secure intranet to provide resources and reports to providers in the CIN 29:30 Focusing on the full panel of patients in the presentation of data and how that leads to success in population health 30:00 Transitioning to telemedicine during the pandemic and how that will impact pediatric care delivery in the future 34:00 Financial results from value-based contracts by focusing on ED utilization, asthma management, well visit completion rates, transitions of care, and quality measures 36:00 Capitalizing on quality improvement projects to decrease exacerbations within asthmatic pediatric population 42:00 Expanding value-based contracts with payers, employers, and Medicaid to prepare for full capitation 44:00 Mental health of children nationally is more important than grades in school (mental health-related pediatric emergency department visits on the rise) 45:00 Integrating behavioral health within primary care and addressing social determinants of health th...