In this episode of The Pediatric Lounge, Dr. Rogu and Dr. Bravo welcome Chip Hart from PCC to discuss practical paths to fairer insurance reimbursement in pediatrics. They delve into the complexities of pediatric payment structures, including disparities in payments based on practice ownership and the impact of insurance models. The conversation also explores broader healthcare issues, including the economic implications of preventive care, the federal government's role in ensuring equitable healthcare, and potential solutions to make pediatric practices financially sustainable.

Highlighting successful practices that have thrived, the discussion underscores the importance of vision, business acumen, and an abundance mindset in pediatrics.

Additionally, the episode emphasizes the significance of the upcoming PMI (Pediatric Management Institute) conference, noting that it offers valuable opportunities for learning, networking, and professional growth. It is mentioned that PMI is fully sold out for in-person attendance but provides a streaming option, with speakers like Sandy Chung and Sue Kressley participating. Special attention is given to a T1D Mastermind Class at PMI with world-renowned pediatrician Dr. Kimber Simmons, showcasing the event as a pivotal occasion for anyone in the pediatric field.

00:00 Welcome to The Pediatric Lounge
00:32 Introducing Chip Hart and Today's Topic
01:02 Understanding Insurance Payments in Pediatrics
02:08 Private Equity and Practice Ownership
03:04 Medicaid and Payment Disparities
05:01 The Single Payer Model Debate
06:34 Value-Based Care in Pediatrics
07:55 Challenges in Preventive Care Funding
10:29 The Role of Managed Medicaid
14:02 Investment in Early Life Healthcare
19:41 Universal Coverage and Moral Hazards
20:14 Historical Context of Healthcare Policies
26:28 The Importance of Preventive Care
31:40 Public Schooling and Healthcare Parallels
40:27 Revisiting the Original Question
41:50 The Economics of Pediatric Care
42:53 Challenges with Insurance and Cash Payments
45:04 The Vaccine Debate and Physician Responsibility
47:29 Incentivizing Preventive Care
49:00 The Importance of Cash Systems in Healthcare
51:33 The New MSMS Codes and Payment Issues
01:01:39 Success Stories in Pediatric Practices
01:08:51 Upcoming PMI Conference and Final Thoughts

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.