Health care has been changing in the United States and organizations that deliver care have had to adjust. Children’s Specialized Hospital President and CEO Amy Mansue told NJ Today Managing Editor Mike Schneider that her organization’s goal is to deliver the highest quality care at the lowest cost. She said New Jersey is in better shape than others when it comes to implementing health care reforms for children, though she admitted it’s difficult to get physicians to undergo the extensive training needed to become developmental pediatricians, which Children’s Specialized Hospital employs for patients.
Mansue said New Jersey had done much of what the federal reform requires, like making sure children have access to prenatal care and insurance, but said the reforms will still impact her organization because patients typically come from trauma centers or other hospitals after being born prematurely. “As those hospitals who also deal with adult patients are challenged with health care reform and challenged with the tremendous cuts that are coming from Medicare — that’s the program that serves the elderly — then that will certainly impact us as well,” she said.
Gov. Chris Christie’s decision to veto a bill that would have created a state run health insurance exchange didn’t surprise Mansue. “He’s been pretty clear that he doesn’t think a mandate is the way to go. He’s also been pretty clear that he’s not sure that this is going to work,” she said. “So why would, as a governor, he want to take that on?”
Mansue added that the federal government will offer an exchange in New Jersey. “The state plan, which is the plan that ensures the most folks in small group, is the plan that defaults anyway so there’s really no downside for him,” she said. “And he can always take it on later.”
Children’s Specialized Hospital, which was started in Westfield 120 years ago, also has out-patient facilities in New Jersey as far south as Egg Harbor Township and as far north as Clifton. Mansue said the out-patient facilities will provide services like occupational therapy, physical therapy, speech therapy, psychology services and visiting physicians.
“They want that access to those services, so our strategy for the last 10 years has been build those out-patient services closer to people’s homes,” Mansue said. “Keep the in-patient hospital in New Brunswick at the center of excellence on the Robert Wood Johnson campus and make sure that we’re able to serve people at all times.”
Changes to health care and insurance companies have affected Children’s Specialized Hospital differently than adult care centers, according to Mansue. “Children’s services are much different than adult services and so for us it’s really trying to anticipate where the child is going to be seen and how they’re going to be seen. If you think about it, 20 years ago, cystic fibrosis, the average age life expectancy was 7. Today it’s 39,” she said. “There are many more children who are saved today who never would have been 20 years ago and so our obligation is to make sure we understand what those services are that they’re going to need and how best to support them.”
Mansue said it is a challenge finding enough students to complete pediatric specialty care training, which takes 10 years in addition to college and medical school. “When you think about the amount of time and the amount of commitment and the amount of money that it costs, it’s really hard for us to make sure we just have enough of those types of docs to serve kids,” she said.
The biggest challenge for Children’s Specialized Hospital, according to Mansue, is reducing costs. “We know that payment is not going to go up, everybody’s been really clear about that,” she said. “So we want to continue to deliver the highest quality care at the most affordable cost in a way that people want to get it.”
Mansue said the way her organization treats patients is more of a community approach in the sense that the entire family is cared for instead of just the patient. “We need to make sure that we can do those three things well — keep the family centered, focused all the time; make sure that we’re providing a cost effective care; and then most importantly, deliver it at the highest quality we can,” she said.