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2018: What's Next in Pediatrics?

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2018: What’s Next in Pediatrics?

Experts: kids’ access to healthcare may be most critical issue

MedpageToday

  • by Staff Writer, MedPage Today

Access to insurance may be the biggest issue for pediatrics in 2018, as pediatricians face challenges from Washington in maintaining children’s access to healthcare through Medicaid and the Children’s Health Insurance Program (CHIP).

“The view of Medicaid as a program that supports working adults is really not the right picture from a pediatric standpoint. Unfortunately this gets way too little understanding by the public or by Congress,” Stephen Daniels, MD, of the University of Colorado School of Medicine, told MedPage Today.

While Congress voted to extend funding for CHIP into the first couple months of 2018, they have yet to pass a more permanent extension to fund the program. Medicaid may also be under fire if Congress attempts to pass another repeal-and-replace bill, with potential cuts to Medicaid funding. One policy expert said that states may attempt to enact “a version of a Medicaid buy-in program.”

“Roughly half our practice in Denver is supported by Medicaid,” Daniels said.

Max Wiznitzer, MD, of University Hospitals Rainbow Babies and Children’s Hospital in Cleveland, highlighted “delivery of appropriate healthcare in the era of insurance restrictions, prior authorizations and resource limitations.”

He also discussed telemedicine as a potential big story, which can allow access to resources for those with travel restrictions or where distance is a factor.

“It has the opportunity to decrease costs (although studies have not demonstrated this result) and, in my opinion, improve health by easier access to quality providers,” Wiznitzer said.

But clinical issues were mentioned as well. Daniels highlighted the continued problem of obesity in young people, due to “such wide ranging adverse impacts.”

“Because we have so few effective treatments, the focus really needs to be on prevention,” he said.

Wiznitzer discussed the potential for gene therapy or enzyme replacement therapy for conditions such as spinal muscular atrophy, Duchenne muscular dystrophy or inborn errors of metabolism. In fact, studies showed gene therapy may have promise for treating Duchenne muscular dystrophy, but the topic remains controversial.

“Limitations are the cost and the functional impact of the therapy (better but still impaired or functional),” he said.

Precision medicine was another potential hot topic. In September, the NIH announced the launch of a specific precision medicine initiative, in order to bring more minority representation into clinical trials.

However, Wiznitzer cautioned that “to date, it has not proven to be as helpful in pediatric neurology as marketed by the companies that offer the service but, with a good understanding of the disorder and the treatment choices, it can be helpful.”

2018-01-05T11:30:00-0500
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At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.

Medpage Today

2018: What's Next in Pediatrics?

Experts: kids' access to healthcare may be most critical issue

MedpageToday

  • by Staff Writer, MedPage Today

Access to insurance may be the biggest issue for pediatrics in 2018, as pediatricians face challenges from Washington in maintaining children's access to healthcare through Medicaid and the Children's Health Insurance Program (CHIP).

"The view of Medicaid as a program that supports working adults is really not the right picture from a pediatric standpoint. Unfortunately this gets way too little understanding by the public or by Congress," Stephen Daniels, MD, of the University of Colorado School of Medicine, told MedPage Today.

While Congress voted to extend funding for CHIP into the first couple months of 2018, they have yet to pass a more permanent extension to fund the program. Medicaid may also be under fire if Congress attempts to pass another repeal-and-replace bill, with potential cuts to Medicaid funding. One policy expert said that states may attempt to enact "a version of a Medicaid buy-in program."

"Roughly half our practice in Denver is supported by Medicaid," Daniels said.

Max Wiznitzer, MD, of University Hospitals Rainbow Babies and Children's Hospital in Cleveland, highlighted "delivery of appropriate healthcare in the era of insurance restrictions, prior authorizations and resource limitations."

He also discussed telemedicine as a potential big story, which can allow access to resources for those with travel restrictions or where distance is a factor.

"It has the opportunity to decrease costs (although studies have not demonstrated this result) and, in my opinion, improve health by easier access to quality providers," Wiznitzer said.

But clinical issues were mentioned as well. Daniels highlighted the continued problem of obesity in young people, due to "such wide ranging adverse impacts."

"Because we have so few effective treatments, the focus really needs to be on prevention," he said.

Wiznitzer discussed the potential for gene therapy or enzyme replacement therapy for conditions such as spinal muscular atrophy, Duchenne muscular dystrophy or inborn errors of metabolism. In fact, studies showed gene therapy may have promise for treating Duchenne muscular dystrophy, but the topic remains controversial.

"Limitations are the cost and the functional impact of the therapy (better but still impaired or functional)," he said.

Precision medicine was another potential hot topic. In September, the NIH announced the launch of a specific precision medicine initiative, in order to bring more minority representation into clinical trials.

However, Wiznitzer cautioned that "to date, it has not proven to be as helpful in pediatric neurology as marketed by the companies that offer the service but, with a good understanding of the disorder and the treatment choices, it can be helpful."

2018-01-05T11:30:00-0500
Comments

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.



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