Medicaid Cuts Could Cause Legislators to Reevaluate Access to Care for Children: Chris Johnson, MBA

Chris Johnson, MBA, CEO and founder of Bluebird Kids Health, spoke about how health care deserts exist all over the country in both rural and urban settings, which makes access to care an important issue for children living anywhere. This, he says, provides an opportunity to see how access to care can improve and implement them through legislative action.

This transcript has been lightly edited for clarity; captions are auto-generated.

Transcript

Are there ways to help health care centers, particularly in medical deserts, who will have fewer funds from Medicaid going forward?

I think there are. I think it's going to require us to continue to innovate and think more about community-based ways to access health care for all Americans, but especially for children. Those health care deserts that you mentioned, they exist in Florida [and] they exist, actually, in just about every major metro area across the country.

I think there are real challenges with rural health. I know there's some funds in the bill that are trying to prop up rural health, but there's actually a challenge in children's health that exists in every single metro area across this country, where, if you look at the 50% highest income zip codes vs the 50% lowest income zip codes and you normalize for population, you see about a 2 to 1 differential in number of pediatricians per 1000 children. That means that children in all cities across the country are struggling to get access to high-quality pediatric care, and that's the care that keeps them out of the hospitals.

The hospitalization rates that you often see for children on Medicaid can be 6 or 7 times the rates of children on commercial coverage, and these are entirely avoidable emergency room visits, entirely avoidable inpatient stays that are incredibly high cost for our health care system, and they're incredibly low quality because kids shouldn't be receiving primary care services in those care settings.

I think the big innovation that this could unlock is, how do we get more community-based providers? How do we get more pediatricians closer to children? How do we democratize access to care? I like to think of that as maybe a silver lining. Can we use some of this legislation to actually open up more access points for those kids where we're getting higher quality outcomes at a lower cost of care?

Boston is my hometown, and it's a very dense place. If you live in Boston Beacon Hill, you have great access to health. You probably have too much access to health care if you live in Beacon Hill. But if you live just 10 miles south, in South Boston, Dorchester, [or] Mattapan, you actually have a lot of struggles getting access to high-quality care.

Even in really dense areas, even in really high-income cities, we still see these really big disparities and access to care that are so important for children. Children's health in this country—one of the great things is we've generally agreed that children should get access to health care regardless of their circumstances. That's my glass-half-full view of 50% of kids [being] covered by Medicaid and CHIP [Children's Health Insurance Program]. The great things we also cover services that are all about setting up children to thrive throughout the rest of their life. We cover preventative screens. We incentivize providers to provide high-quality care and have folks come in for annual wellness visits. We invest in vaccinations that we know prevent these really horrible, debilitating diseases like polio. I think it's really amazing that we do that, and we just have to, as a system, make sure that the care delivery apparatus that I'm a part of gets and finds those kids and brings them into the system.