Finding Medicaid Coverage for Kids

ARE OVER 2 MILLION CHILDREN ENROLLED IN MEDICAID. THIS ENSURES ACCESS TO COMPREHENSIVE LOW-COST HEALTH COVERAGE. AND IT'S A VITAL SAFETY NET FOR LOW-INCOME FAMILIES. HOWEVER, PEDIATRICIANS ARE NOT LEGALLY REQUIRED TO ACCEPT MEDICAID FOR ROUTINE CARE THAT LEAVES SOME FAMILIES TO CONDUCT EXTENSIVE RESEARCH TO FIND A PROVIDER THAT ACTUALLY ACCEPTS THEIR INSURANCE. IT CAN ALSO LEAD TO WEEKS WAITING FOR APPOINTMENTS ARE TRAVELING LONG DISTANCES JUST FOR BASIC CARE. >> CHRIS JOHNSON IS THE CEO AND FOUNDER OF BLUEBIRD KIDS, HEALTH. >> HE JOINS US NOW FROM BOSTON FOR MORE ON THIS GROWING CONCERN AND HOW TO GET HELP FINDING PEDIATRIC CARE. WELCOME TO OUR SHOW TODAY. THANK YOU FOR HAVING ME. CHRIS. CAN YOU FIRST EXPLAIN WHAT IS MEDICAID AND HOW IT DIFFERS FROM MEDICARE AND AND WHO IT IS SUPPOSED TO HELP. >> ABSOLUTELY. WHEN YOU THINK OF THE U.S. HEALTHCARE SYSTEM, THERE ARE 3 PRIMARY PAYERS OF HEALTH CARE SERVICES, MEDICARE, WHICH PROVIDES INSURANCE FOR PEOPLE WHO ARE 65 AND OLDER. WE HAVE COMMERCIAL INSURANCE, WHICH IS MOST FOLKS RECEIVE THROUGH THEIR EMPLOYER. WE'RE POTENTIALLY THROUGH THE HEALTH INSURANCE EXCHANGES AND THEN MEDICAID, WHICH IS ANOTHER GOVERNMENT PROGRAM THAT IS FOCUSED ON POPULATIONS THAT ARE LOWER INCOME AND CANNOT AFFORD COMMERCIAL INSURANCE OR HAVE VERY COMPLEX MEDICAL NEEDS. >> ABOUT HOW MANY CHILDREN IN OUR COUNTRY ARE ARE ENROLLED IN THIS PROGRAM. >> YEAH. SO SO THE GENESIS OF ONE OF THE CORE POPULATIONS BACK IN THE 60'S WHEN IT WAS ESTABLISHED BY THE GOVERNMENT WAS TUPPER ENSURE THAT ALL CHILDREN HAD ACCESS TO MEDICAL CARE AND BELIEVE IT OR NOT. OVER THE LAST SEVERAL DECADES TODAY, NEARLY 50% OF CHILDREN IN THE U.S. ARE COVERED BY MEDICAID OR ANOTHER PROGRAM CALLED THE CHILDREN'S HEALTH INSURANCE PROGRAM, WHICH IS SIMILAR OFFERING MEDICAL CARE FOR CHILDREN UNDER 18 YEARS OF AGE. >> AND WHAT ARE THE BIGGEST CHALLENGES FACING PARENTS WITH KIDS ON MEDICAID? THEY NEED TO GET THEIR KID IN TO SEE A DOCTOR. I'M GOING TO SPECIFICALLY FOCUS ON FLORIDA AND SOUTH FLORIDA. WHAT IS THE BIGGEST CHALLENGE? >> YEAH, IT ACCESS TO CARE IS AN INCREDIBLY LARGE BARRIER FOR THESE FAMILIES AND IT REALLY FALLS INTO 2 CATEGORIES ONE IS THAT, WELL, 50% OF CHILDREN ARE COVERED BY MEDICARE, MEDICAID. GENERALLY. IF YOU LOOK AT THE AVERAGE PEDIATRICIAN PANEL, WELL, UNDER 50% OF THAT PANEL, OUR CHILDREN, MEDICAID, IT'S ON AVERAGE 15 OR 20%. SOME PEDIATRICIANS DON'T ACCEPT MEDICAID ON THEIR PANEL. SO THERE'S THAT DYNAMIC OF JUST AND NOT ENOUGH. PEDIATRICIANS ARE ACCEPTING MEDICAID. THE SECOND CHALLENGE THAT YOU THEN SEE IS THAT WHAT THIS HAS LED TO WHAT WE CALL A PEDIATRIC CARE DESERTS WHERE AROUND ALL MAJOR METRO AREAS, IF YOU LOOK AT THE LOWEST INCOME COMMUNITIES IN THOSE METRO AREAS, THE NUMBER OF PEDIATRICIANS IS ABOUT 50% AS THE HIGHER INCOME ZIP CODE. SO THERE'S ACTUAL LIKE PHYSICAL ACCESS BARRIERS ON TOP OF JUST CHALLENGE IS ACTUALLY FINDING A PEDIATRICIAN IS GOING TO ACCEPT MEDICAID. >> WHAT ABOUT PEOPLE IN RURAL AREAS? IT'S EXACTLY WHAT YOU'RE MENTIONING. YOU KNOW, THEY MAY LACK ACCESS PHYSICALLY TO GET TO A CLINIC, CORRECT? >> CORRECT ITS ROLE. BUT THE INTERESTING THING IS, IS ALSO SUBURBAN. SO EVEN WHEN YOU WHEN YOU LOOK AT COMMUNITIES LIKE FORT LAUDERDALE WIN, YOU LOOK AT JACKSONVILLE, THE PEDIATRICIANS THAT ARE THERE TEND TO BE CLUSTERED IN THE MIDDLE TO HIGHER INCOME COMMUNITIES AND LOWER MIDDLE CLASS TO LOW-INCOME COMMUNITIES HAVE SIGNIFICANTLY HIGHER ACCESS BARRIERS. AND THAT'S TRUE OF RURAL COMMUNITIES. BUT IT'S ALSO KIND OF AN URBAN SUBURBAN CHALLENGE THAT CAN EXIST AS WELL. >> AND YOU FOUNDED BLUEBIRD KIDS HEALTH. I KNOW YOU RAISED. I THINK IT WAS 31 MILLION IN CAPITAL FROM INVESTORS LAST YEAR. WHAT DOES YOUR COMPANY DO AND WHAT IS THE MISSION OF THE COMPANY? >> YEAH, OUR OUR ORGANIZATION SEEKS TO PROVIDE EXCEPTIONAL CARE SO ALL CHILDREN CAN THRIVE. AND THAT'S OUR MISSION. THAT'S AT THE CORE OF WHAT WE DO AND HOW WE MAY CALL FOR DECISIONS. WE ACTUALLY BUILD A RETAIL PEDIATRIC PRACTICES. SO THINK IN LARGE SHOPPING, PLAZAS, WE LOCATE THOSE IN AREAS THAT ARE WHAT WE CALL PEDIATRIC CARE DESERTS. SO WE MAP GEOGRAPHY AS WE LOOK AT THE NUMBER OF CHILDREN, LOOK AT THE NUMBER OF PEDIATRICIANS PER 1000 CHILDREN AND WE FIND THE COMMUNITIES THAT DON'T HAVE GOOD ACCESS TODAY, BUILD A NEW ACCESS POINT. THERE. AND THEN WE ENSURE THAT WE WE CONTRACT WITH ALL THE INSURANCE PLANS IN THE COMMUNITY. SO WHETHER YOU HAVE A KIND OF A CADILLAC AND, YOU KNOW, COMMERCIAL INSURANCE PRODUCT OR YOU'RE COVERED BY ONE OF THE MANY MEDICAID PRODUCTS IN THE STATE WERE ABLE TO GET ACCESS AT OUR AT OUR CLINIC. >> WHAT IS YOUR ADVICE FOR MOMS AND DADS WITH KIDS ON MEDICAID? THERE ARE NO PROVIDERS ARE. THEY'RE STILL WAITING TO GET THEIR KIDS SCENE. YOUR FACILITIES AREN'T IN SOUTHWEST FLORIDA YET. WHAT WOULD YOUR ADVICE BE? >> YOU KNOW, WHAT WILL BE COMING TO SOUTH OF FLORIDA SOON. HOPEFULLY BY THE END OF 2027. SO SO AT THAT POINT, WE HOPE WE HOPE YOU'LL COME TO BLUEBIRD KIDS, HEALTH. IN THE MEANTIME, IT REALLY IS, YOU KNOW, BEING IN A ROW, A STAUNCH ADVOCATE FOR YOUR CHILDREN CALLING AROUND TO ALL OF THE PEDIATRICIANS. IT IN THE COMMUNITY, CALLING THE PEDIATRICIANS THAT ARE FILLED WITH LOCAL HEALTH SYSTEMS. REALLY THAT KIND OF KNOCK KNOCK DOWN THE DOOR AND BE ABLE TO TAKE TO GET THROUGH UNFORTUNATE. THERE'S NOT A GREAT, YOU KNOW, SECRET STASH OF PEDIATRICIANS AROUND TO BE ABLE TO ACCESS. IT IS ONE WHERE YOU HAVE TO, YOU KNOW, FIGHT, FIGHT, FIGHT FOR ACCESS TO THAT JUST DON'T GIVE UP. PEDIATRICIANS WANT TO DO THE RIGHT THING. THEY WANT TO PROVIDE CARE FOR ALL CHILDREN ARE SOME OF THE STRUCTURAL BARRIERS AROUND MEDICAID REIMBURSEMENT CAN MAKE THAT QUITE CHALLENGING TO THAT. >> AND I JUST WONDER YOU'RE YOU'RE SO INVOLVED IN THIS LEGISLATIVELY. WHAT IS YOUR OPINION TO THINK MORE SHOULD BE DONE ON THE LEGISLATIVE FRONT TO HELP THESE CHILDREN HAVE ACCESS TO MEDICAID? I THINK YOU. >> ACCESS TO MEDICAID FOR FOR CHILDREN GENERALLY ISN'T ISN'T A HUGE PROBLEM ARE ACTUALLY PRETTY GOOD ABOUT ENSURING THAT CHILDREN CITIZEN CHILDREN, OF OF THE OF THE COUNTRY HAVE ACCESS TO MEDICAID AND THAT THE CHALLENGE AND WHAT WE NEED FROM A POLICY PERSPECTIVE IS FOR MORE OF THOSE DOLLARS TO FLOW THROUGH TO COMMUNITY-BASED PROVIDERS WHO ARE REALLY PROVIDING THIS ESSENTIAL FRONTLINE PROACTIVE PREVENTATIVE CARE FOR CHILDREN AND BUILDING TRUST WITH FAMILIES SO THAT, YOU KNOW, MOMS AND DADS KNOW THAT THEY'RE DOING THE BEST THING THEY CAN DO FOR THEIR FOR THEIR CHILDREN. SO THAT'S THAT'S WHAT I SAY. LOOK, MAKE SURE THAT MORE OF THOSE RESOURCES ARE GOING TO THE COMMUNITY BASED PROVIDERS CREATE THE INCENTIVE FOR MORE ACCESS TO DEMOCRATIZE THE SYSTEM AND AS A COUNTRY, ONE OF THE ONE OF THE REALLY INTERESTING THINGS IS WHEN WE LOOK AT KIND OF SOME OF THE LIFE EXPECTANCY GAPS BETWEEN THE U.S. AND OTHER DEVELOPED COUNTRIES, MOST OF THAT DELTA, MOST OF THAT, YOU KNOW, THE 4 SO FEWER YEARS THAT AMERICAN IS EXPECTED TO LIVE VERSUS A LOT OF WESTERN EUROPEAN AND OTHER WEALTHY COUNTRIES IS DRIVEN BY CIRCUMSTANCES. THAT HAPPENED IN THE FIRST 18 TO 21 YEARS OF LIFE. WE NEED TO MAKE THESE INVESTMENTS IN CHILDREN. IT'S HOW WE'RE GOING TO INCREASE OVERALL LIFE EXPECTANCY, AN OUNCE OF AN INTERVENTION EARLY REALLY CHANGES THE LIFELONG TRAJECTORY OF CHILDREN. AND IT'S GOING TO HELP MAKE MORE THRIVING COMMUNITIES ACROSS THE STATE OF FLORIDA, BUT ALSO ACROSS ACROSS THE COUNTRY.