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The Helping Kids Cope Act Means a Fresh Look at Pediatric Billing and Working with Pediatric Medical Billing Companies

Finding new opportunities for pediatric billing is critical to maintaining the health of pediatric medical practices, and new legislation might be a change that aligns with the health of the children and families you care for. As you review the act, look for opportunities to expand pediatric medical billing and coding services. 

Understanding the Helping Kids Cope Act
The Helping Kids Cope Act (H.R. 2412) is bipartisan legislation designed to support the pediatric mental health workforce and give kids better access to the full continuum of mental health care. It does this by establishing new grant programs at the Health Resources and Services Administration (HRSA) for urgent needs for pediatric mental and behavioral healthcare. The grants take on the task of [1]:

  • Improving children’s access to support and community-based services. This happens through the strengthening of community-based pediatric mental health services, enabling pediatric care communities to implement and develop the new policies and programs that meet the unique mental and behavioral health needs of their patients. 
  • Expanding and enhancing the pediatric mental health workforce. Through the expansion of mental and behavioral health training, care communities will see an increased capacity of the current pediatric health workforce and support for recruitment and training of new pediatric mental health professionals. 
  • Investing in critical pediatric mental health infrastructure. When critical pediatric mental health infrastructures are expanded, the country will see improvement in the national capacity to deliver the best care possible for the children who have more intensive needs. These include inpatient psychiatric care, as well as step-down care like day programs and intensive outpatient services. 

 

How Pediatric Providers Should Respond
Anyone responsible for pediatric medical billing and coding services should look at this as an opportunity. 

Pediatricians are often the sole source of care for kids with mental health issues. This means that pediatricians are increasingly stepping up as mental health care providers. And pediatricians have been doing a good job. Research has found that when a pediatrician prescribed medication for a child who has depression or anxiety, it was generally done appropriately. But only one of out three children who were prescribed medication were also referred to a therapist [2]. 

This reveals that there is a gap in pediatric mental health care – and one that can be addressed by providers who are willing to expand the services they offer. These providers should consider this when looking for additional sources of revenue – the avenues opened up by the Helping Kids Cope Act mean the potential for new service lines and potentially the opportunity to leverage the help of pediatric medical billing companies to make sure your revenue cycle stays as healthy as possible. 

Consider the idea that, if children are in a position where they warrant medication, they should also be receiving other services. Eric Butter, chief of psychology at Nationwide Children’s Hospital in Columbus, Ohio emphasizes the fact that children who are given medication should also be receiving some form of counseling, saying that “a pill never taught a kid how to cope better.” Only a minority of children appear to be referred to a therapist, largely because of the lack of mental health specialists available. 

For pediatricians, this means an opportunity to consider offering billable services by bringing on providers such as psychologists, psychiatrists and other mental health care providers into their practices. Pediatricians have an amazing amount of leverage here in encouraging the use of any services they do decide to add on since families are leaning on them for guidance in navigating mental health issues. 

How Pediatricians Can Move Forward
It’s important to understand the services you might be adding. Mental health issues are prevalent in patients under the age of 18 [3]:

  • Over half of children have some type of disorder
  • Almost 20% have a specific phobia
  • Depression affects 18.6%
  • 12.6% are diagnosed with oppositional defiant disorder
  • ADHD affects 8.1%

Many pediatricians and pediatric trainees feel that they are not prepared to address these behavioral and mental health problems – which is exactly why expanding the services you offer and working with pediatric medical billing companies can be a win-win for your patients and your financial health. 

Improving Pediatric Medical Billing and Coding Services
As awareness of the resources available to children spreads, expect to see parents pushing for more access to mental and behavioral healthcare. 

There will be an increase in use of services from psychiatrists, psychologists, therapists, counselors and other types of mental health professionals, and you do not want to wait to figure out your strategy as things shift. Know that your parents will be asking questions about where they can access the best care for their children, and providers who offer these services within one practice will have a competitive advantage over other pediatricians. You should anticipate that some parents will be open to switching providers for the smoothest mental health experience possible for their children, giving preference to providers who offer more services in one practice. 

This means now is the time to lay out the services you might want to offer and figure out how they could increase your cash flows. Keep in mind that bringing on any of these services can put extra pressure on your revenue cycle, which is why you should also be considering working with pediatric medical billing companies to ensure the smoothest possible transition for your staff and your patients. 

If you are looking for options in pediatric medical billing companies, contact us today so we can help you formulate a revenue cycle strategy that aligns with your behavioral and mental health planning for the future.

References
[1] Children’s Hospital Association, “Bipartisan Legislation Would Invest in Children’s Mental Health Care and Workforce,” 24 May 2023. Available: https://www.childrenshospitals.org/content/public-policy/policy-position/helping-kids-cope-act.
[2] A. Norton, “For Kids With Mental Health Issues, Pediatricians Are Often Only Source for Care,” HealthDay, 17 April 2023. Available: https://www.usnews.com/news/health-news/articles/2023-04-17/for-kids-with-mental-health-issues-pediatricians-are-often-only-source-for-care#:~:text=%22Pediatricians%20can%20effectively%20identify%20mental,be%20therapists%2C%20Butter%20pointed%20out.
[3] The American Board of Pediatrics, “Behavioral and Mental Health,” 2023. Available: https://www.abp.org/foundation/behavioral-mental-health.

Pediatric Medicine’s Struggle with Labor Shortages and Other Limitations
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Pediatric Medicine’s Struggle with Labor Shortages and Other Limitations

Pediatric medicine supports some of the most vulnerable members of society. This makes shortages in the space even more concerning. Unfortunately, the same shortages of resources and professionals that plague the rest of the healthcare industry also impact pediatric medicine.

For leaders in this area, it means having to free up revenue so they can invest in solutions through options like working with pediatric medical billing companies or examining their relationships with pediatric medical billing and coding services.

To help you understand the forces that are driving these considerations, we’ve compiled some of the top challenges in pediatric medicine today.

Pediatric Hospital Beds Are Limited
Today, the number of hospitals that offer pediatric services has dropped from 42% a decade ago to just 37% [1].

For at least 10 years, the number of pediatric beds available has been trending downward. As of 2018, one in four American children were traveling greater distances for a bed compared to their trips in 2009, according to the journal Pediatrics. This was largely due to a decrease in the number of children who needed care before the COVID-19 pandemic. Compared to 2017, 2019 saw around 200,000 fewer pediatric discharges. But overall, care has improved in helping children with conditions like cystic fibrosis and sickle cell, and prevention has improved for problems like meningitis and pneumonia through vaccination programs.

As anyone working with pediatric medical billing and coding services will know, pediatrics is seasonal, with patient numbers falling in the summer and rising again during respiratory virus season in the winter. But, at the beginning of the pandemic, daycares and schools closed, which meant COVID and other infectious diseases were spreading more slowly among children, decreasing the need for hospital beds. In many cases, beds that had been dedicated to children were shifted to care for adults. 

Childrens’ Hospitals Are Struggling
Nursing shortages have hit some of the most vulnerable providers. Even before the COVID-19 pandemic, children’s hospitals were being threatened by workforce shortages. Nursing school enrollment was falling short while at the same time, there was a shortage of faculty to help train new nurses. Some hospitals have even reported retirement rates that doubled in 2021. Many nurses were working through the pandemic, enduring waves of shortages, then inactivity. In the midst of all this, they were deciding as to whether it was a good time for them to finally leave the workforce. Just like nurses in general, nurses in the children’s hospital space want work life balance and are taking advantage of opportunities in contract work. 

The nurse turnover rates for Children’s hospitals are severe. According to data out of PROSPECT, a leading financial and operational data set in pediatrics, the quarterly turnover rate increased more than 76% for registered nurses when comparing the first quarter of 2019 to quarter three of 2021 [2]. The critical shortage of pediatric nurse practitioners has been a point of concern as far back as 2019. 

These hospitals have also reported that travel nursing is especially effective in luring nurses away since it allows nurses to pay off student loans and other debt. This means that for hospitals to stay competitive, they should be willing to increase pay rates. This is a good reason for children’s hospitals to consider pediatric medical billing services to help ensure that their cash flows are as healthy as possible and that they have strong revenues to provide the higher compensation that is attractive to pediatric nurses. 

Pediatricians and Pediatric Specialists Are Hard to Find
The country is facing a shortage of pediatricians. As far back as 2021, it was estimated that the US could experience a shortage of thousands of physicians in pediatrics [3]. Some states are having particular struggles, such as Florida, which has a worsening need for pediatricians. 

Pediatric medical subspecialists are critical to the health of children since they treat patients with special needs. When there are shortages of these professionals, patients have to travel long distances for care. Some wait multiple weeks or even months, sometimes skipping care or being forced to get care from providers who don’t have the appropriate training. 

The American Academy of Pediatrics reports on shortages around the country. These reports are broken down by state and include information on driving distances. Some of the subspecialties covered include [4]:

  • Pediatric cardiology
  • Pediatric infectious diseases
  • Sports medicine
  • Child abuse pediatrics
  • Neonatal-perinatal medicine

One of the potential suggestions on the fact sheet is loan repayment for pediatric subspecialists to ease access to additional training and encourage more doctors to specialize in treating children with special health needs. 

The common theme among these challenges is that forms of compensation such as pay and other financial support is important to countering these shortages and attracting talent. For providers, this means that it is critical to invest in the health of the pediatric revenue cycle today. This can be done multiple ways, including working with pediatric medical billing companies, and investing in pediatric medical billing and coding services. To learn more about how you can address these concerns, contact us today. 

References
[1] C. Zdanowicz, “Pediatric hospital beds are in high demand for ailing children. Here’s why,” Cable News Network, 17 March 2023. Available: https://www.cnn.com/2023/03/16/health/pediatric-hospital-bed-shortage-ctrp/index.html.
[2] M. M. Busenbark, “Children’s Hospitals Work to Address Nursing Staffing Challenges,” 26 April 2022. Available: https://www.childrenshospitals.org/news/childrens-hospitals-today/2022/04/childrens-hospitals-work-to-address-nursing-staffing-challenges.
[3] AAMC, “AAMC Report Reinforces Mounting Physician Shortage,” 11 June 2021. Available: https://www.aamc.org/news/press-releases/aamc-report-reinforces-mounting-physician-shortage.
[4] American Academy of Pediatrics, “Pediatric Subspecialty Shortages Fact Sheets,” 26 March 2021. Available: https://www.aap.org/en/advocacy/pediatric-subspecialty-shortages-fact-sheets/.

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