October 1, 2015 | (28) Comments

As we move about the day, working alongside our colleagues, we might be surprised at the journeys some of them have traveled.

Take Kathy Green and her husband, Kurt. Both are Texas Children’s employees. In fact, Kathy has been at Texas Children’s about as long as I have. She met her husband here, and they have two children, ages 6 and 8. Kathy and Kurt are not only employees, they are also one of our patient families. Their children have used the services in about 60 percent of the departments at Texas Children’s.

Most of the family’s visits are for the Greens’ son who has major medical complexities, including immunodeficiency. For six years, Kathy has been his advocate and care manager, and she’s endured the challenges of coordinating care for a child who requires multiple specialists.

Because she’s a nurse and she’s immersed in the Texas Children’s system, Kathy’s an experienced, informed advocate for her son. But she has said that she often wonders how others do it. How do families who can’t afford the critical care and treatments needed for children with major medical complexities get the support they need? How do they even begin to understand the medical issues or navigate the complex, patchwork health care system for their children? Who’s looking out for them to make sure they receive the right care when and where they need it?

We are, Kathy. Yesterday, the Health and Human Services Commission of Texas announced a new contract with Texas Children’s Health Plan that will help close the gap for children who have major medical complexities.

This is a milestone several years in the making. Five years ago, I received a letter from Texas State Representative John Zerwas with a call to action. In response to the Affordable Care Act, Rep Zerwas asked for Texas Children’s help in developing an innovative approach to the way we serve children. He is a physician as well as a legislative leader, so he knows that the basic and most fundamental tenet of the Affordable Care Act is being able to provide access to the right care, at the right time and the right place — a fundamental tenet of Texas Children’s model of care.

Right away, I met with Texas Children’s Health Plan President Chris Born to discuss how we could create a better model for care, decreasing costs for the state while increasing efficiency for our patient families. Since then, Chris has worked diligently to re-configure the way we support families of medically complex children.

Currently, the system lacks proper coordination of care for children with medical complexities. Often, their physicians don’t communicate, which leads to a gap in what happens to these children once they leave the hospital or clinic setting. And their parents are left in charge of navigating the extraordinarily complicated health care system.

For the past few years, Chris worked intensely with the state to advocate for and develop a different approach to care for this population, which means moving these kids out of a fee-for-service model into a managed care model, where case managers can help take the burden off parents. Ultimately, the state supported the idea of a more comprehensive, coordinated approach to care for medically complex children and created the STAR Kids Program. And yesterday, almost five years to the day after that call-to-action letter from Rep Zerwas, Texas Children’s Health Plan was awarded STAR Kids designation to provide Medicaid Managed Care for children with medical complexities.

Through Texas Children’s Health Plan and a handful of other designated plans throughout the state, the STAR Kids Program will provide health coverage to children and teens with special health care needs, including benefits such as prescription drugs, hospital care, primary and specialty care, preventive care, personal care services, private duty nursing, and durable medical equipment and supplies.

The STAR Kids contract will allow the Health Plan to increase its reach to about 40,000 new children and teens in 54 counties. These children see multiple specialists and therapists, and many receive home care services. They typically see at least one physician every week. We will hire nearly 400 new case managers to help these patients coordinate care between their multiple providers and assist them in navigating the complicated facets of health care. Coordination and management of care helps prevent children with significant intellectual development disabilities or complex medical problems from falling through the gaps and provides a structure where their progress can be followed throughout the system.

This new care model is a huge step in supporting the unique needs of these patients and their families, and improving their access to health care services, while also reducing preventable events or unnecessary visits to the hospital or care provider.

This milestone and Texas Children’s involvement is the result of Chris’ passion and hard work over the years. He has spent countless hours pursuing better options for these children and encouraging the state to adopt a more robust, coordinated model of care. Now, it is a reality with Texas Children’s Health Plan leading the way.

We’ve responded boldly to Kathy’s question of “who?” From Day One, Texas Children’s has always answered the call, and because of the passion and vision of so many here, we will continue to do so for decades to come. It’s our mission.

August 6, 2015 | (38) Comments

Making tough decisions typically is not fun. But leaders must have the discernment to make tough calls every day, and as President and CEO of Texas Children’s I am no exception. Yet what I’ve learned in my 25 years here is that if I make decisions that remain focused on what’s best for our patients and their families, we usually land on the right track and success follows.

That’s exactly what happened 20 years ago when Texas Children’s Physician-in-Chief Dr. Ralph D. Feigin and I were grappling with whether to start a network of pediatricians affiliated with Texas Children’s. It was the mid-90s, a time of great change for the health care industry. Several Houston-area pediatricians approached Dr. Feigin to talk about the challenges they were facing managing the business end of their practices while keeping up with what they do best – caring for patients. Hospitals across the country responded to similar concerns by creating pediatric primary care group networks. Many of them, however, did not do so well. They didn’t seem to have the appropriate leadership, business model or commitment to high quality care and service.

Knowing this, Dr. Feigin and I were apprehensive about starting a group practice affiliated with Texas Children’s. But we knew it was the right thing to do for our patients. We knew we needed to create a way for families to access high quality primary care to compliment the comprehensive pediatric subspecialty care provided at Texas Children’s.

By forming Texas Children’s Pediatrics, we gave families in the Greater-Houston area the opportunity to receive pediatric primary care from leading pediatricians associated with one of the best children’s hospitals in the nation. We also allowed physicians to focus on medicine while business leaders and support staff at Texas Children’s handled their practices’ billing, payroll and other back-office responsibilities.

Texas Children’s Pediatrics has helped us take better care of the kids in our community, strengthened our ties to the best pediatricians in the Greater-Houston area and helped us nurture a pipeline of gifted young physicians trained at Baylor College of Medicine to our practices.

Doing what was best for our patients and families was the impetus for Texas Children’s Pediatrics. It is now the largest pediatric primary care network in the nation with more than 200 board-certified pediatricians and 50 practice locations. Each year, the group sees nearly 400,000 patients and has more than 1 million patient encounters. That’s a long way to come in just 20 years and a great reason to celebrate a milestone anniversary.

This video spotlights Texas Children’s Pediatrics’ 20th anniversary.

As part of my One Amazing Team tour, I am visiting all of our practice sites. This week, I stopped by Texas Children’s Pediatrics Ashford, our first practice, which, at that time, was owned by the four Rosenthal brothers – Drs. Morris, Paul, Ben and Harry Rosenthal. Drs. Ben and Harry Rosenthal are still caring for patients with the same zest and zeal they had when they started their careers. And now Dr. Ben’s daughter, Dr. Rachel Rosenthal Bray, has become part of the family’s legacy of dedication to and passion for pediatric primary care.

All of the Texas Children’s Pediatrics staff and employees I’ve visited during the tour thus far share this same passion. They are extremely talented people who are dedicated to meeting the Texas Children’s mission of creating a healthier future for children. Pursuing that common goal creates a network of expertise like no other.

Over the past two decades, I’ve been reminded time and again what a solid decision Texas Children’s Pediatrics was for our patients and families, and I am proud of what we have accomplished together. Congratulations to all of the staff and employees at Texas Children’s Pediatrics for 20 years of work extremely well done. I know there is much more success to come.

June 4, 2015 | (1) Comments

This is a very special time of year for students and their families. It’s the month that graduates – from curious kindergartners to bright doctoral and medical students – walk across the stage to receive their hard-earned diplomas.

I recently had the honor of participating in the commencement ceremony at Baylor College of Medicine, as I have on more than 20 other occasions. Watching the medical and doctoral students receive their diplomas, I am always excited to think about how they will advance medicine to unknown heights in just a few short years, some even at Texas Children’s.

This year’s ceremony was especially moving for me since I was bestowed a very special recognition, an honorary degree – the Doctor of Humanities in Medicine.

As I received my honorary doctorate and shook the hand of Dr. Paul Klotman, Baylor’s President and CEO, I reflected on how my relationship with Baylor began. In 1977 when I joined Houston Methodist, Dr. Michael E. DeBakey was Baylor’s president and was regarded as the number one cardiovascular surgeon in the world. I remember how aspirational he was about making Baylor a great medical school.

I learned a great deal from Dr. DeBakey about the importance of teaching hospitals. I began to understand that what contributes to the success of great academic centers of excellence – teaching hospitals like Johns Hopkins, Mass General or Boston Children’s, for example – is their affiliation with a medical school which attracts the best minds and the brightest individuals. Our partnership with Baylor allows us to also benefit from the brightest minds who bring their passion and commitment to Texas Children’s.

I carried that knowledge and Dr. Debakey’s wisdom with me to Texas Children’s, which has had an affiliation with Baylor since its inception more than 60 years ago. Today, we have a complementary mix of Baylor faculty and outstanding private pediatricians, surgeons and Ob/Gyn physicians who choose to practice at Texas Children’s and are dedicated to fulfilling our mission. This culture of commitment to excellence, as part of our academic partnership, is essential to our goal of preeminence as one of the best pediatric and women’s health centers in the nation.

I would be remiss if I didn’t acknowledge the tremendous work and dedication of everyone associated with Texas Children’s – the Board, executive and physician leaders, our extraordinary employees and everyone else who is somehow involved in our commitment to patient care, education and research. It is your dedication that allowed me to celebrate that very special moment.