Pediatric Primary Care in United States
The American Academy of Pediatrics, in an urgent response to proposed changes to the health care system, published a policy statement that supports maintaining the structure of the Medicaid program, including the expansion, and opposes any sacrifice in gains made toward providing comprehensive, high-quality and affordable health care for all U.S. children. Pediatric Primary Care in United States
The AAP policy statement, “Principles of Child Health Care Financing,” will appear in the September 2017 print issue of Pediatrics but will be published online July 17. The statement affirms the belief that public and private health care insurance should safeguard existing benefits for all infants, children, adolescents, and young adults through age 26. The Academy recommends taking additional steps to further reduce uninsurance rates, ensure coverage of essential benefits, and remove operational barriers to timely access to care.
“Our first principle as physicians is to do no harm,” said AAP President Fernando Stein, MD, FAAP. “The long-term costs to society will be much higher if we don’t provide essential care for our youngest, most vulnerable populations today.”
More children and young adults have become insured since passage of the Affordable Care Act (ACA) than at any time since the creation of the Medicaid program in 1965. Since the ACA became law in 2010, the uninsurance rate for children younger than 18 has dropped from 9.7 percent to 4.8 percent. This historic reduction in the number of uninsured children is in large part because the Medicaid program, the Children’s Health Insurance Program (CHIP), and key ACA changes in employer-sponsored and marketplace health plans have worked together in a coordinated way. Current congressional and Administration proposals will reverse this progress, leading to higher rates of uninsured children, lower levels of needed benefits, and reduced access to developmentally appropriate care throughout the full span of childhood. Pediatric Primary Care in United States
At the same time, the United States has benefited from advances in pediatric health care, resulting in decreased infant mortality, increased immunization rates, and a decline in the rate of preventable hospital admissions for children.
“As a country, we have made incredible strides over the past decade in reducing the number of children without health insurance by over 50%, in increasing the coverage of essential benefits for children, and in making insurance affordable to families and children who could not previously obtain coverage. we simply cannot afford and must vigorously oppose relinquishing these gains so as not to harm children,” said Mark L. Hudak, MD, FAAP, a lead author of the report.
“The United States can and should do more to make sure that no child lacks access to necessary health care.”
In its policy statement, the AAP calls for Congress to improve the patchwork of public and private insurance programs, expand Medicaid funding to ensure the continued access to the 37 million children who rely on this program, and extend funding for CHIP for five more years. CHIP covered 8.9 million children in fiscal year 2016 alone, the statement observes.Pediatric Primary Care in United States
According to the AAP, a comprehensive health care system should include these goals:
- Universal, quality, and affordable health insurance for all who live in the United States, regardless of income, family composition, or immigration status, from birth through 26 years of age. Pediatric Primary Care in United States
- Coverage of essential pediatric benefits. These include but are not limited to prenatal and newborn care; postnatal home visits; preventive and wellness services; urgent and emergency care; and services for dental treatments, behavioral and mental health care, reproductive health, and treatment of substance abuse disorders.
- “Cost-sharing” expenses [copayments, deductibles and coinsurance charges] that are structured to enable preventive care, encourage wise use of other medical care, and are affordable in relation to family income.
- Adequate provider payments to strengthen the medical home and help physicians coordinate services and care.
“Reforms aimed solely at cutting costs for health care will harm children,” Dr. Stein said. “We should evaluate what works or doesn’t work in the current model and focus on improving the system where it has short-comings. This will require a thoughtful, comprehensive approach.”The Department of Pediatrics invites applications for a clinical associate position within the Division of Primary Care. This position would have a shared time of 50/50 at the nursery and also at Duke Children’s Primary Care Brier Creek. This pediatrician would be half newborn nursery attending and half primary care pediatrician in an established office with other experienced clinicians. Pediatric Primary Care in United States
Eligible candidates must hold an MD degree and be board certified or board eligible by the American Board of Pediatrics.
The Division of Primary Care Pediatrics is dedicated to providing excellent clinical care, training the next generation of pediatricians, advancing our knowledge of ways to improve the health of children, and improving the health of our community. As the largest division within the Duke Department of Pediatrics, we provide expert patient care at Duke Children’s Hospital & Health Center and our affiliated locations.
We are dedicated to providing comprehensive well-child and acute care for infants through age 25. We provide a wide array of high quality, accessible primary, specialized and enhanced health care services for our patients. Our wellness services include immunizations and routine physical examinations, including those required for school, competitive athletics, and camp.
We offer comprehensive care for the entire range of childhood illnesses. All of our pediatricians are members of the faculty at the Duke University School of Medicine and are board-certified. The faculty and staff in the Division of Primary Care Pediatrics constantly work to improve our health care knowledge in order to provide our patients with state-of-the-art care.
The Research Triangle Park is a globally prominent hub for high-tech research and development. Conceived around three major universities in the cities of Durham, Chapel Hill, and Raleigh, the region attracts and fosters cultural diversity, economic resilience, and a spectrum of personal and professional options. To learn more about the Duke and Greater Triangle communities, visit: http://community.duke.edu/ Pediatric Primary Care in United States
Pediatric nurse practitioners (PNPs) specialize in providing a range of healthcare services to children from birth to early adulthood. Among nurse practitioners, there are two main subfields of practice: acute care and primary care. An acute care pediatric nurse practitioner (PNP-AC) focuses on patients with complex, acute, critical, and chronic illness, disability, or injury, while a primary care pediatric nurse practitioner (PNP-PC) emphasizes health promotion, disease prevention, and the management of minor episodic and chronic health problems.
The scope of practice for both acute care and primary care is based on patient need, and not necessarily setting-specific; however, primary care often takes place in a private practice or school-based clinical settings, while acute care usually takes place in emergency rooms, urgent care departments, and trauma centers.
There are many areas of overlap between primary care and acute care nurse practitioners, but also critical differences in schooling, certification, job duties, and continuing education. Pediatric Primary Care in United States