In the health care landscape, often dominated by discussions of senior care and chronic disease management, innovation is changing the spotlight to an increasingly overlooked but important population: children.
“In major metro areas, when you actually map a 50% highest income postal code and a 50% lowest income ZIP code, there is often a 2-to-1 difference between pediatricians per person.”
Recently, Bluebird, which raised $31.5 million to expand its innovative pediatric healthcare platform, aims to bridge the gap in access to primary care for children, especially Medicaid.
Johnson said he aims to apply the concept of accessibility to pediatric care by establishing a high-quality clinic called the “pediatric desert.”
Pediatric deserts are not always remote. Instead, there could be just a few miles from a bustling and reliable community. This inconsistency leaves children in low-income areas where access to basic health care is limited.
“I don't think primary care is properly utilized in this country,” Johnson said. “Value-based care actually allows us to return the right primary care model to provide the best care for our patients and are adequately compensated for the care that those providers provide.”
Value-based care model for children
Over 50% of US children are eligible for Medicaid, but Johnson says many pediatricians either cap or try not to accept the number of Medicaid patients they see because of their low reimbursement rates.
“It's not for evil purposes,” Johnson said. “Many pediatricians are small and medium-sized companies and can only support the majority of Medicaid fee reimbursement rates before you get unprofitable.”
The impact of this gap in care is important. According to Johnson, the healthcare use patterns for Medicaid children are similar to those in Medicare populations with emergency department visits and hospitalizations with higher emergency department visits and hospitalizations.
“We shouldn't,” he said. “That's not because they're dramatically sicker than the other kids, because we've actually evolved as a healthcare system so that they don't have access to primary care.”
Bluebird operates under a value-based care model that focuses on inclusive care that integrates physical, behavioral and social health services. The platform is designed to reduce reliance on emergency services by providing aggressive and preventative care.
“It's a real victory for the patients, a victory for the doctors who practice with our model, and a victory for the overall health system,” Johnson said.
“One of the first things we focus on is to make sure we return medical joy and joy to the documents that we join our team,” he added. He said the model is particularly appealing to those who are disillusioned by service fee constraints.
Navigate healthcare headwinds
Still, the broader healthcare industry continues to face major challenges, including an impending shortage of doctors and potential Medicaid reductions.
Johnson believes the business model is viable amidst policy changes so long as Bluebird shows measurable improvements in patient outcomes and cost reductions.
“We are still very focused on delivering great clinical outcomes for the children we have the privilege to serve,” he said.
Bluebird Kids Health uses a robust set of robust key performance indicators (KPIs) to measure their impact. These include patient growth, quality indicators of care, emergency and inpatient utilization, and satisfaction scores from both patients and staff.
“We're like a two-sided platform,” Johnson said. “The patients need to be very excited and the team needs to be very excited.”
As Bluebird Kids Health grows, the company aims to build sustainable and scalable models that can be replicated nationwide. While Florida still has a focus for the time being, Johnson envisions a future in which Bluebird Clinic serves children in communities across the country.
He is also exploring ways in which artificial intelligence (AI) and genai can enhance service delivery. From reducing the management burden of providers to providing educational tools to caregivers, technology plays a key role in Bluebird's strategy.
“We see great opportunities for AI to help people with education for asthma and manage allergies and other conditions,” Johnson said.
