Dear Mr. Rogers, 

I recently received a letter regarding a significant reduction in the fees Blue Cross/Blue Shield is willing to pay to Pediatric Associates of Austin.  As you review your financial bottom line and the way that you choose to set your priorities as an insurance provider I hope you will keep in mind the way a pediatric practice affects the lives of those you serve. 

The first pediatric provider I found for my children emphasized cost savings over quality health care.  On my first visit I waited for two hours in a waiting room with my two-day-old twins (weighing approximately five lbs.) in a room full of sick children during flu season.  I saw my children's primary care provider once and was generally shuttled off to a PA, it took days to schedule appointments and during late nights with feverish children I spoke to an automated nursing service.  The practice did not have a lab and we never took a culture on what was most likely a severe case of thrush.

 I then researched other care providers and moved my children to Pediatric Associates.  At Pediatric Associates newborn children are brought in through a back door and seen immediately.  Separate waiting rooms are provided for well and sick children.  A nurse or pediatrician that is familiar with my child's history is available 24 hours and they provide care on the weekends. 

This is how it should be.  This may not be the most cost effective way provide Pediatric care but it is the safest and the most responsible.  At Pediatric Associates their priorities are clear -- as a parent I can rest assured that the doctors and administrators put my children's health before their financial gain.  I can back this up with first hand experience.

In one notable example my child's primary care provider made a diagnosis and submitted a culture for a disease that shared the same symptoms as a virus that was going around. The lab result came through as a rare bacterial infection -- the consequences of a delayed culture or a missed diagnosis could have been dire.  It is my understanding that your reduction in reimbursements for lab fees will also undercut their ability to provide on-site lab results.   Please keep in mind that one child with an infectious disease diagnosed quickly and treated accordingly protects hundreds of other children.  With children the spread of disease occurs rapidly and exponentially...in terms of lab results...hours, not just days, can make a difference.  And, as is always the case in good policy decisions, a quick diagnosis of one child ultimately saves you money as well.

Unfortunately children do not get to choose when they get sick and I have lost count of how many times I have used Pediatric Associates on the weekends or after hours.  The alternative would have been a visit to the emergency room which would have cost you significantly more.  In your zeal to cut immediate costs you may be losing track of how you really save money. Remember, the good will of those who carry your insurance and smart decisions on their part also save you money.  Imagine if every parent who has used a 24 hour nurse or weekend practitioner at Pediatric Associates chose instead to visit the emergency room.  In your decisions to cut cost I ask you not only to be caring in the way you view pediatric care but also to be smart and look beneath the surface at the hidden savings you get from a quality pediatric care provider. 

My story is only one among many I have heard from friends and acquaintances who understand what an extraordinary job Pediatric Associates does.  I suspect you will hear many more. The quality of health care a child receives sets the tone for a lifetime of good health.  How reckless and short-sighted it is to disable a pediatric practice that protects the long term health and wellness of the future adults you provide coverage for.

Over the years I have seen a steady erosion in the coverage you offer my family -- higher costs of prescription medicine and an increase in my co-pays.  Although I am not happy about it, I have willingly absorbed these changes.  However, a direct assault on my children's care provider is unacceptable. 

This is a decision you need to explain and justify publicly -- not an administrative accounting decision to make behind closed doors.  Several times now you (BCBS) have tried to levy these cuts and then shrank back when you have been held accountable in the light of public dialogue.  A pattern is becoming clear.  Perhaps it is time for us parents to make a concerted effort to make this a very public dialogue and insure that we protect our pediatric practice for the long run...not just another year. 

My husband has served as a statewide elected official in Texas for 16 years.  During his tenure, he made it a priority to protect the quality of health coverage offered to his employees and the people of Texas.  Please understand that your pending decision will be watched closely and with great concern by a diverse group of Austin parents as well as state and local public policy makers.  As I include more people in this dialogue I will be forwarding copies of this letter to you along with their contact information.  I look forward to hearing more from you. 

Respectfully,

 

Concerned Mom (Name withheld)