Improving health exams, promoting health for children: Minnesota pediatrician tries new approach

Each year, tens of thousands of children visit the Minnesota Children’s Clinic in Minneapolis for monthly or semi-annual well-child visits. As a result, pediatrician Patricia Hickey sees many patients in a short period of time.

She said doctors may have as little as 20 minutes to assess a child’s physical growth, illness, medication and vaccine needs, development, behavior and mental health.

“It is absolutely impossible to reach everything we want to achieve. Everything we know is important for the health of children,” she said. “I wish I had more time, but that’s just not the reality in the world these days.”

Physicians may not have the power to extend the day, but Hickey and other pediatricians are experimenting with programs that effectively add professional time before and after important child checkups.

The hospital is partnering with Healthy Steps, a national nonprofit organization for children 3 and under that partners child development experts and pediatricians to help families get more out of regular checkups. There is.

In 2023, approximately 9,000 children under the age of 3 were served across two Minnesota facilities. The feedback is so promising that state officials are currently in discussions with HealthySteps and local pediatricians about allowing HealthySteps to bill the state’s Medicaid program for its services.

By teaming up with Healthy Steps experts, Hickey and his colleagues can help identify health and developmental concerns in their youngest patients and help struggling parents navigate the health care system. It is also said to be helpful.

“We see kids here in our clinic who may not have access to other resources in the community,” Hickey said. “So we wanted to give them some of those resources and help bridge the gap.”

“Talk to your family about what they see.”

HealthySteps currently operates out of two locations in Minnesota: Children’s Minneapolis and St. Cloud CentraCare Health.

At Children’s, HealthySteps Specialist Kim Zack meets with parents before their child’s pediatrician visit to answer initial questions and ease concerns about the process.

“I want to talk to families about what they’re feeling from their children,” she says. “What do they actually want to see that they do very well and be proud of? And what are the resources that exist within the community that make parenting easier?”

Part of the job involves helping parents understand normal early childhood development and allay some of their fears.

“An example of them might be a child who has a really bad temper and bites, hits, or kicks them. Children don’t like to be told no, and parents may want to set limits. It’s a struggle,” Zach said. “These are all developmentally normal behaviors for a 2- or 3-year-old child. And sometimes having a family member tell you that this is actually very normal can help frame it. .”

She added that when parents go to see a doctor, they come in without much anxiety.

Is it worth the cost?

Zach connects families with community resources that can improve child development and support families struggling with housing and food insecurity. More than 60% of the families who use HealthySteps nationwide also qualify for Medicaid.

She hopes the initiative will expand, but it will take some effort and effort to get state Medicaid programs to pay for it.

HealthySteps Analytics provides evidence of low costs and high return on investment. For just $50 per child per year, you can hire a full-time professional to provide clinical care, and your efforts will pay off by reducing the amount your state spends on child care in the future. the company says.

The nonprofit organization estimates that every dollar spent on HealthySteps saves state Medicaid agencies $2.63.

The program is not yet billable through Minnesota’s Medicaid program, known as Medical Assistance. But the state Department of Human Services is in contact with nonprofit organizations and local pediatricians.

“Our job is to share innovations across the state and get more of those norms so that state Medicaid agencies can incorporate them and feel comfortable that they are not legal action. , and strive to open up more innovative avenues,” said Jennifer Tracy, Senior Director of Growth and Sustainability at Healthy Steps National Office. “They can actually follow the framework of what other countries have done.”

Minnesota Department of Human Services officials said they are looking at how other states are implementing new claims models before making a decision in Minnesota.

“I highly encourage other clinics to develop this program in their own clinics if they have the opportunity,” Hickey said. “This could really benefit families and clinicians, and could be a win-win. It brings more resources to families and helps close the inequities.”