|
|
|
President's Perspective
|
By Jennifer Mellick, MD, FAAP
I recently attended the AAP National Convention and Exhibition (NCE). I have gone several times now and in the last several years I have worn the hat of KAAP executive board member. Each time I attend a meeting or talk at NCE that applies to my role as a KAAP board member I am reinvigorated and challenged by so many examples of how pediatricians make a difference in their chapters. I leave with ideas of things to bring back to Kansas to help Kansas kids. I highly encourage every pediatrician to attend at least once. It is awe inspiring to see how many people make caring for kids their life's calling. It also gives me a chance to communicate with other pediatricians who have unique perspectives on what the challenges are and will be for America's children. It broadens my view of what is important and helps me to get out of my fairly privileged box.
Arguably, the continuing education I get at NCE is the least important thing I do there. I could get CME online. The most important thing I get is the communication with others. I think communication is the key to any relationship and truly good communication exists when all parties listen twice as much as they speak. We are striving to do just that here in the KAAP. We want to hear from our members and are working on creating new avenues to do just that. A new recurring column will be featured in each of our newsletters to communicate issues that Kansas pediatricians are having with payment entitled "Pediatric Payment Corner". Please send any problems you are having with payment and our Pediatric Council will get to work on trying to find a solution. If we find a way to make your lives easier in terms of reimbursement for the great work you all do on behalf of Kansas kids, we will publish it in this ongoing column.
We are also grateful for all the communicating you do on behalf of Kansas kids. The KAAP board wants to highlight and thank our members Dr. Abbie Rube and Dr. Brian Harvey who wrote a letter to the editor about issues with Access to Care for Kansas children, highlighting Medicaid Expansion that appeared in the Salina Journal. We also know that many others are speaking out for Kansas kids. Send us your articles or other ways you are reaching out for our patients. We would love to give you some recognition. As we approached the recent November election, the KAAP Public Policy Committee wrote weekly emails encouraging you all to get out and vote for kids. We will continue to communicate how our new administration in both the US and Kansas will affect our practices and our patients.
No matter what your political persuasion is, we all knew that this election would bring change to children's policies. I think with any change comes some uncertainty. For some, this is a very scary time. I know I don't have any answers to these questions and I believe that only time will tell whether this change will be good or not, but I am holding tight to something Mr. Fred Rogers from one of my favorite childhood shows - Mr. Roger's Neighborhood said, - "When I was a boy and I would see scary things in the news, my mother would say to me, 'Look for the helpers. You will always find people who are helping." Pediatricians are by definition helpers and I know that no matter what happens come January 1, nothing can change that.
|
|
Pediatric Payment Corner
|
By Jonathan Jantz, MD, FAAP
Welcome to the new KAAP Pediatric Payment Corner! This will be a regular
addition to the KAAP member newsletter. The goal is to keep KAAP members
aware of the Payment Issues in the state and provide an email address to forward any issues you are experiencing.
Pediatric Payment Issues:
Denial of payment for claims of a well child exam and sick visit on the same day.
This is a disturbing occurrence that has begun to be more frequent. Example: a child has a well visit in the morning and returns later that day with a broken arm.
Click here
to read more about same day claim denial issues, payment denials, and documentation suggestions.
Issues with Medishare/ Christian Care Ministries which is under Multiplan/ PHCS (Private Healthcare System) and meeting payment deadlines.
Click here
to read more about the difference between insurance companies, medical sharing plans, and repricing agents and the issues they present to providers.
Tell us Your Pediatric
Payment Issue:
|
| Issues & Commentary |
By Dennis Cooley, MD, FAAP, KAAP Legislative Coordinator
The elections are finally over and in one of the biggest surprises in election history Donald Trump has won the presidential election of 2016. A look at how this, and other results, can affect health care and children's issues.
FEDERAL
As mentioned above, Donald Trump surprised many pundits and Washington insiders with a stunning victory November 8th. The biggest concern for the AAP is the unknown. Just how receptive will the new administration be to the AAP's Blueprint for Children? The AAP is non-partisan and the Blueprint was not written for one administration over the other so I am sure the AAP will move forward with it. But it will be hard to plan ahead with so much unknown.
- Will the ACA be repealed?
- Is Medicaid expansion still viable?
- What about funding for CHIP which is up for re-authorization in 2017?
- Who will head HHS and CMS?
These are just a few of the major questions facing our Department of Federal Affairs staff. Also, Republicans now control the legislative and executive branches of government so ideas such as block grants for Medicaid will get new life. The makeup of the national congressional members from our state will change only slightly as all incumbents running in the general election won. Republican Dr. Roger Marshall ousted incumbent Tim Huelskamp in the primaries and won in the general election and will be the only new member from our state. As Chair of the Subcommittee on Access, I am again a member of the Committee on Federal Government Affairs so will be traveling to DC and talking with congressional staff from our state. I will keep you informed on the happenings at the national level.
STATE
Results of the elections in the state took a different course. The Legislature seems to have moved more toward the center. Democrats and Moderate Republicans made significant gains. According to the Topeka Capital Journal, 35 moderate Republicans and 40 Democrats were elected to the statehouse. This changes the makeup and means Moderates and Democrats now can control the House. The Senate also moved to the center and Democrats gained one seat. This was interpreted as a rebuke of the Governor's handling of the budget and his tax plans. Although we should see some changes, don't expect a wholesale makeover. Of more significance is that all of the Supreme Court justices were retained and they are expected to make a big ruling on the case concerning school financing. This will have a major impact on the budget and again affect children's programs and safety net supports. The changes in the makeup of the state legislature make chances of Medicaid expansion improved, but now with the possibility of repeal of the ACA that expansion is up in the air. To help the Chapter deal with the many issues affecting the health of children, last year we set up a Public Policy Committee. I expect this group will be very active this year and again we will keep you informed of happenings in the state that will affect you and your patients.
|
The Kansas WIC Program
Screening for Anemia & Elevated Lead Levels - Sharing Information |
By Dave Thomason, Director, Kansas WIC Program
In practice, pediatricians assess for anemia and elevated lead levels and then, if appropriate, perform a test of the patient's blood. When you provide care for patients who also participate in the WIC program, questions may arise about the screening for anemia or elevated lead levels performed by WIC or other health department staff. This article will help answer some of these questions and start the discussion to explore solutions to identified problems.
To be certified as eligible to participate in the WIC program both an assessment and screening for low iron blood levels are required no more than 60 days prior to the certification. WIC uses a finger stick or a non-invasive hemoglobin screen for a quick hemoglobin screening. If a client has a very low hemoglobin, they are referred to their PCP for more thorough testing. They are also educated about high iron foods and asking their PCP for an iron supplement recommendation. Individuals who are at low income levels, including those eligible for WIC services, have a higher risk of anemia than those at higher income levels.
Some Kansas health departments also screen for elevated lead levels in blood. The WIC program requires only assessment for elevated lead levels and does not provide screening. Nevertheless, a WIC participant may be screened for elevated lead levels by a WIC staff member with the costs being charged to another program and funding source. Since the client isn't informed about the funding source, she may understandably believe that the lead screening was provided by the WIC program. If your patient says she or her children were tested for lead during a WIC appointment, understand that it was really not part of the WIC process.
|
| Environmental Health Issues & Resources |
 By Jennifer Lowry, MD, FAAP
"Dr. Lowry? I read on the internet that I shouldn't feed my child rice cereal. Is this true?"
Pediatricians love children. Pediatricians love helping children become the best people that they can be. Pediatricians love doing what is needed to make the world a better place for children to be healthy. What pediatricians don't love is being caught unaware of the latest blog, internet chat or media storm regarding environmental health issues. Media and other news outlets often inform parents of possible environmental exposures that can cause harm to children. Unfortunately, not all of the information is true which causes undo concern for parents and confusion to pediatricians who are asked about these effects.
What is a pediatrician or family to do? It is important to realize that we are surrounded by stuff. We, or the people who have come before us, have made choices that puts stuff in our world that are supposed to make things "better" or "easier". Unfortunately, not all of the stuff that we encounter fits both. Cell phones, plastics, better beef, lead in paint, and synthetic athletic fields are just a few examples that may make life easier, but might not (or, definitely not, in some cases) make life better. But, today, everywhere you turn, someone is saying that our children's lives are damaged by the chemicals that we have in the environment. Is this true?
As a toxicologist, I have been taught that "everything is a poison, it is just a matter of the dose". Paracelsus was a Swiss German Renaissance physician, botanist, alchemist, astrologer and general occultist. He founded the discipline of toxicology. He rejected the medical conditions of the times (late 1400s), and pioneered the use of chemicals and minerals in medicine. He is credited with the phrase, "the dose makes the poison", but he is also known to have said, if given in small doses, "what makes a man ill also cures him". Thus, he realized that medicines can be beneficial at low doses but cause harm at higher doses.
|
| KPF Update |
The Turn a Page. Touch a Mind.® (TAP-TAM) program is the largest program supported by the Kansas Pediatric Foundation (KPF). Since 2004, TAP-TAM has grown to include 83 sites in 46 counties with 474 primary care providers giving more than 120,000 books to Kansas kids each year. This program is loved by participating physicians, parents and children across the state who agree that TAP-TAM books spark a love of reading in children at a very young age.
Currently the KPF Literacy Endowment is not able to keep up with the growing program, and there are several practices on the waiting list who would like to promote early literacy through TAP-TAM. Rising book costs and the slowdown in market growth have made it a priority of KPF to increase the Literacy Endowment so that TAP-TAM can not only maintain current sites, but continue to grow in the future.
We have put more than 750,000 books into the hands of Kansas kids because of the generous support from KAAP members, and we hope that Chapter members will contribute this year to keep TAP-TAM going strong in Kansas.
You can donate online here, or mail in a gift to:
Kansas Pediatric Foundation
PO Box 860481
Shawnee, KS 66286
|
| Kansas Breastfeeding Friendly Practice Designation |
The Kansas Breastfeeding Friendly Practice Designation trainers have been busy training practices across the state to become "Breastfeeding Friendly". An important part of each on-site training has been to make sure that practices are familiar with local breastfeeding resources. We have seen some great collaborations in Kansas communities to support breastfeeding over the last few months.
The following sites have earned their Kansas Breastfeeding Friendly Practice Designation:
5 Stars
Children's Mercy West Clinic in Kansas City
4 Stars
Pediatric Partners, PA in Overland Park
Heartland Primary Care in Lenexa
Sites who have participated in the on-site training and are working on their designation:
- KU Department of Family Medicine, Kansas City
- Drs. Morris and Hill Medical Clinic, Fredonia
- Hutchinson Clinic Pediatrics, Hutchinson
- Ashley Clinic, Chanute
To find out more about the Kansas Breastfeeding Friendly Practice Designation, contact Mel Hudelson at (913) 530-6265 or
mel.hudelson@kansasaap.org.
|
| You Are Invited to Join Our Asthma ECHO! |
by Carla Deckert, MA and
Michael
Lewis, MD, FAAP
KU ECHO Project
Are you interested in learning how to enhance your ability to diagnosis and monitor your patients with Asthma - while getting free CME? We will be offering you the opportunity to participant in a unique collaborative tele-education opportunity over a secure videoconferencing network. You don't have to leave your office to join. Our Asthma ECHO (Extension for Community Healthcare Outcomes) will occur once a week for four weeks beginning next February, 2017. The ECHOs will each last one hour - from noon to 1:00 pm on Wednesday.
Through ECHO our role is to facilitate a group discussion on how to help all asthma patients achieve the goal of living with well-controlled asthma. Pediatricians understand that asthma is one of the most common, chronic, and costly conditions our patients face. Therefore, our collective goal is to help them receive the most comprehensive and coordinated care designed to control their condition.
The educational plan for this ECHO will be focused on the following components of evidence-based guidelines:
- Diagnose and identifying the severity of symptoms using pulmonary function (spirometry)
- Review the best types of medicine for asthma control and when to increase, decrease or change
- Work with your patient and his/her family to develop an Asthma Action Plan
- Learn new asthma treatments and therapies
We will also include a session on pediatric and adolescent behavior to help secure adherence to the plan by your patients.
Each session will include a de-identified case presentation by you or one of your peers, followed by discussion and suggestions so you can decide on the best practices for your clinic. The educational portion of the ECHO will include a 15 to 20 minute didactic presentation by one of the University of Kansas Medical Center's ECHO Asthma Education Interdisciplinary Team.
The impact of asthma on the health of children in Kansas is significant. It is estimated that in Kansas that 23.5% (1) of children will be told they have a diagnosis of asthma by the time they finish high school. Added to the health impacts are the number of days children miss school - and the opportunity of learning - because of asthma.
As members of the Kansas Chapter of the American Academy of Pediatrics, we are each aware of the toll asthma takes on our patients. By joining the Asthma ECHO, we can learn, collaborate, educate and disseminate to our colleagues information to offer our patients the highest quality asthma care.
To learn more about our Asthma ECHO or sign-up to participate, please e-mail:
ProjectECHO@kumc.edu or call Carla Deckert at 913-588-2081.
|
|
|
|
|
