Always Look to the Future for Inspiration
Despite everything they have going on, KPP makes sure to keep an eye on the future. Having a full pipeline is the key to staying current and innovative. They think about what they will need to bring to market in three to five years, basing decisions on things that parents need answers to but aren’t getting enough of currently. For example, with kids spending more and more time online, KPP wants to increase education around digital media literacy and safety.
Other plans include increasing mental health services. Dr. Wolynn has a pilot going embedding a mental health navigator into pediatric primary care. Currently there are not enough providers of substance abuse and mental health counseling working in pediatrics, and not enough kids receiving these services in general, whether in or outside of the pediatrician’s office. This can be due to a lack of availability of practitioners, a stigma to patients going outside of the medical home, billing codes that can’t be used, and the silos of mental health versus physical health that sometimes negate providers treating both simultaneously. But Dr. Wolynn feels strongly that kids need to get mental health services where they already have an established sense of trust and care – their pediatrician’s office. “Pediatricians have a golden opportunity to begin [providing mental health services] where someone trusts you with the life of their child [the pediatrician’s office],” he says. “If you reduce yourself to sick and well care only, you miss this opportunity.”
Dr. Wolynn is currently working to integrate licensed clinical social workers into the practice. They will be able to get credentialed with insurance companies, and have their services billed out. This will allow KPP to “close the loop” with in-house care. Already into the third year as a Level 3 Patient-Centered Medical Home (PCMH), they had been using clinical care coordinators to connect patients with mental health providers in the community. But patients would not always follow through and make appointments with them. Lack of patient compliance is all too common when referring out to specialists. Having in-house social workers would not negate the need for clinical care coordinators. Rather, they could work in tandem to organize and provide the care they need. Social workers are also trained to address more than mental health issues; they are well-suited to intervene around food or housing insecurity issues as well. This adds to the holistic approach that KPP is working toward providing all patients.
As far as other trends Dr. Wolynn sees coming down the pike, he shares: “Social determinants of health worry me. Other countries spend half of what we do on healthcare, but more on social spending [to address things like] housing and food insecurity, toxic stress, adverse childhood experiences. These are the things that impact kids into adulthood. A lot of our work is addressing that much more comprehensive picture. We’re a destination, a community engagement space. We are trusted. We want to help you address all these other things.”
KPP does a great job providing all kinds of resources to address the big picture of kids’ health and community engagement. But, as Dr. Wolynn says, things like The Well are great, but they come with a cost. “If you offer a better product, you get more money in most fields. But with insurance companies, you offer a better product and you still get the same amount for it.”
Commenting on the current state of healthcare, Dr. Wolynn says: “There is no slack in the system anymore. With more layers of regulations and compliance, and technology, expenses go up every year. What we are seeing now with contracts for pediatricians, is that they can’t measure value very well in pediatrics. You get held to well visit rates and immunizations information. Pediatrics is the gateway to the rest of health…we impact outcomes down the road. With payments for quality of care or preventive care, you don’t see the dollars shifting. The money isn’t going up, it’s going down. Things are so tight. Other groups we know are taking austerity measures – laying off staff, reducing office supplies.”
This state of affairs is one of the reasons Dr. Wolynn stresses the importance of adding all of the additional services to a practice. With insurance payments for visits declining, it’s important to have other offerings that can pick up the slack. “You can be the best pediatric practice in the world, but if you get closed out of the loop, you can still cave to being bought out,” he says.
