Group Description

Members

Meeting Minutes

Work Group Committees (work group members only)

Group Description

     In 2004, the federal Maternal and Child Health Bureau formed an Expert Work Group on Pediatric Subspecialty Capacity to develop strategies to improve access to pediatric subspecialty care in coordination with a comprehensive, community-based medical home. The Expert Work Group is addressing all 30 pediatric subspecialties, including those certified by the American Board of Pediatrics, the American Board of Medical Specialties, and other specialty boards.

     The Expert Work Group on Pediatric Subspecialty Capacity was established in response to mounting evidence that access to pediatric subspecialty care is a serious problem in many parts of the United States.  Families, physicians, hospitals, academic institutions, managed care organizations, and state health agencies increasingly have been reporting particularly acute problems in child and adolescent psychiatry, neurology, developmental-behavioral pediatrics, endocrinology, and also pulmonology, rheumatology, nephrology, gastroenterology, and emergency medicine. Inadequate access to most other pediatric subspeciaties has been reported as well.   

     Several interrelated factors appear to contribute to pediatric subspecialty capacity problems.  Among the most important is the relatively small number of pediatric subspecialists being trained in the United States and the lengthy period of their training time along with the lack of special training programs for general pediatricians and family physicians interested in assuming greater pediatric specialty competencies.  Low reimbursement fees and the failure of most insurers to recognize codes for consultation, communication, and coordination codes also adversely affect pediatric subspecialists’ capacity, especially their availability to collaborate more closely with medical home providers. Further aggravating the problem are increases in the prevalence of certain chronic childhood conditions (e.g., ADHD, autism, diabetes) and in the survival of children with complex conditions (e.g., cancer, hemophilia, HIV/AIDs).

     The consequences of pediatric subspecialty capacity problems significantly impact the availability of comprehensive, community-based care for children and adolescents.  Specifically, shortages affect access to care, health outcomes, and costs of care.  Families are experiencing longer waiting times to see a pediatric subspecialist, often as long as six months, depending on the specialty. These access problems are affecting all children, although greater access difficulties are being reported for children covered by Medicaid and those who re uninsured.

     The Expert Work Group is comprised of leaders affiliated with federal and state governmental agencies, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatrists, the American Board of Pediatrics, the Child Health Corporation of America, Family Voices, the National Association of Children’s Hospitals, Shriners Hospitals, the American Association of Medical Colleges, and various academic and health policy institutes.  The work group will meet periodically through 2007.  The Washington, DC office of the Maternal and Child Health Policy Research Center is providing staff support. 

     The Expert Work Group has three main objectives:  1) defining the scope of current and projected pediatric subspecialty capacity problems and their effects on morbidity, productivity, quality, and costs; 2) identifying promising approaches for improving shared management between pediatric subspecialists and medical homes, reimbursement, education and training, and collaborative state/regional delivery system networks; and 3) developing recommendations and a tactical plan to improve access to pediatric subspecialty care within the context of a comprehensive, community-based medical home.     

     For further information, please contact Stephanie Limb (slimb@mchpolicy.org or 202-223-1500) at the MCH Policy Research Center.

[top]

Members

Polly Arango

President, Algodones Associates, Inc.

Peter Armstrong, MD, FRCSC, FACS, FAAP

Chief Medical Officer

Shriners Hospitals for Children

Richard Azizkhan, MD

Surgeon-in-Chief, Lester W. Martin Chair of Pediatric Surgery

Professor of Surgery and Pediatrics,

Cincinnati Children’s Hospital Medical Center

Richard Behrman, MD

Executive Chair,

Pediatric Education Steering Committee

Federation of Pediatric Organizations

Jennifer Cernoch, PhD

Executive Director, Family Voices, Inc.

Russell Chesney, MD

Le Bonheur Professor and Chair, Department of Pediatrics
University of Tennessee-Health Science Center

Randall Clark, MD

Chair, American Society of Anesthesiologists’

Committee on Pediatric Anesthesia

Richard Cooper, MD

Professor of Medicine
Leonard Davis Institute of Health Economics
University of Pennsylvania

Atul Grover, MD, PhD
Associate Director, Center for Workforce Studies

Association of American Medical Colleges
 

Vidya Bhushan Gupta, MD, MPH

Director of Developmental Pediatrics,

Metropolitan Hospital Center
 

Ethan Jewett

Senior Health Policy Analyst,

Division of Graduate Medical Education and Pediatric Workforce

American Academy of Pediatrics

Douglas Jones, Jr., MD
Professor, University of Colorado School of Medicine

Department of Pediatrics, Section of Neonatology
Children's Hospital
 

Wun Jung Kim, MD, MPH

Visiting Professor, Department of Psychiatry

University of Pittsburgh

John Lewy, MD

Professor and Chair Emeritus, Department of Pediatrics

Tulane Health Sciences Center

Donald Lighter, MD, MBA

Associate Director of Medical Affairs

Shriners Hospitals for Children

Jeffrey Lobas, MD

Director, Child Health Specialty Clinics

University of Iowa Carver College of Medicine

Patrick Magoon

Chief Executive Officer,

Chicago Children’s Memorial Hospital

Holly Mulvey

Director, Division of Graduate Medical Education and Pediatric Workforce

American Academy of Pediatrics

Richard Pan, MD, MPH

Associate Professor of Clinical Pediatrics,
Director, Communities and Physicians Together

University of California-Davis Medical Center

Robert Schwartz, MD

Professor of Pediatrics and Chief of Pediatric Endocrinology,

Department of Pediatrics

Wake Forest University

Calvin Sia, MD

Chair, AAP Professional Advisory Committee of

the National Medical Home Initiative for CSHCN 

Christopher Stille, MD

Assistant Professor of Pediatrics,

University of Massachusetts Medical School

James Stockman, MD

President, American Board of Pediatrics

Fan Tait, MD

Director, Department of Community and Specialty Pediatrics

American Academy of Pediatrics

Thomas Tonniges, MD

Medical Director, Boys Town Pediatrics

Director, Boys Town Institute for Child Health Development

Peters Willson

Vice President for Public Policy,

National Association of Children’s Hospitals

[top]

Meeting Minutes

January 15-16th, 2004

(click here to download a pdf copy)

November 15-16th, 2004

(click here to download a pdf copy)

February 15-16th, 2006

(click here to download a pdf copy)

[top]