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EPA location2 sm1Eugene Pediatric Associates has achieved another critical milestone — we were the top pediatric clinic (by far) in performance of Coordinated Care Organization (CCO) Quality Metrics for our region.

What is a CCO? It’s an innovative idea in Oregon where health care providers (physical health care, mental health care and sometimes dental care providers) have agreed to work together to serve people who receive health care coverage under the Oregon Health Plan (Medicaid). EPA is part of a CCO.

This new concept in paying clinics based on specific quality measures is called “pay for performance.” The idea is to give better care to more people for less money. Seventeen broad quality measures in Oregon touched both pediatric and adult medical care. The measures specific to Eugene Pediatric Associates’ performance were:

  • Follow up office visits at least every 12 weeks with children who have ADHD.
  • Mental and physical health assessment of children placed in foster care within 60 days of placement.
  • Emergency Room utilization decreases.
  • Adolescent well checks at least once per year.
  • Developmental screening at well checks before age three.
  • Patient-Centered Primary Care Home enrollment.
  • Patient satisfaction/access to care questionnaires.
  • Electronic Health Record adoption.
  • Screening for depression.

Those clinics that had an outstanding rating for quality and number of patients served received more money. Those clinics serving fewer patients or underachieving on the metrics received less. That we did an outstanding job on these metrics speaks to several factors.

First, our clinic was rewarded for being on the leading edge of technology and change. When the drumbeat of health care reform made it clear to me that a conversion from paper charts to electronic was needed, and when the PCPCH program was announced, we did not wait, we led our field. The complicated and expensive transition to electronics, which included adding staff to attend to the million new details, paid off. The results have all benefitted the kids we serve.

Second, Eugene Pediatrics is the perfect size to make rapid transformation. Change is hard, especially when hundreds or thousands of doctors and nurses are forced to change work habits they have had for decades. Larger, more corporate clinics are struggling in this new paradigm. When it’s a smaller clinic like ours, we can meet as a team, talk about new regulations and implement them quickly.

Third, and perhaps most importantly, our patients are engaged. Look again at the list of requirements and notice that several of them depend upon patients doing what is in the best interests of their kids:  

  • Come for well checks.
  • Answer detailed developmental questionnaires.
  • Utilize expensive emergency room care only in a true emergency.

We at Eugene Pediatrics work hard to reach out to you and give our best care at every opportunity, and you respond. For that, we are truly grateful. Working together, we can make the greatest positive impact for your kids’ health.

Health care reform is moving quickly in a very new direction. Instead of paying for services given, doctors in the future will be paid if their clinics meet increasingly complex quality metrics. For now, it’s mostly the government-insured system leading us in this direction, but private insurance companies also are starting their own quality metric programs.

Eugene Pediatric Associates is ready for all of that because, ultimately, we must meet these challenges and be a leader if we are to do what we love the most: earn your trust and take care of your precious children. Every step of the way.

Posted by on in News

140701 EPABlogImageThrive1A traditional pediatric practice helps lots of kids, but I am convinced it barely scratches the surface of what many children need. The physical health of a child is only a portion of wellness. The other key aspect is mental and behavioral/developmental health.

Eugene-Springfield has many wonderful mental and behavioral health caregivers and agencies for kids, but coordinating care with pediatricians is always a challenge. After nearly 15 years in practice here, I became frustrated with the limitations in my traditional practice to meet the needs of the children we serve.

So, one sunny autumn afternoon last year, I asked my favorite child psychologist, Dr. Jenny Mauro, to have coffee and talk about the exciting possibilities of pediatricians working side by side with child psychologists, developmental pediatricians and child psychiatrists.

If that happened, I could step out of my exam room and grab a specialist in child mental health and development to get a “curbside consult.” My families could meet a behavioral health care provider for a momentary “hello” and know whom they would meet during an upcoming visit. And scheduling the behavioral health visit at the same location would be a breeze.

Coordination of care would be so easy and even fun. Brown bag lunches with my doctors sitting around the same table with psychologists and other behavioral specialists would make it easy to discuss children in need of our team approach.


Posted by on in News

roths final
We are preparing for a busy and exciting summer at Eugene Pediatric Associates! Three providers are joining us: Dr. Peter Sidor, Dr. Amelia Roth and certified physician assistant John Roth. You’ll want to read more about these truly wonderful people. (And that's the Roths and their beautiful daughter, Greta, in the photo with me!) 

The to-do list for my management team and me to prepare for their start dates — July 27 for Dr. Sidor and September 1 for the Roths — is pages long, including the mountain of paperwork necessary to credential them with hospitals and insurers. But we want to ensure a smooth start and attend to everything they need, from to the smallest of details — even making sure their leather doctor bags are ordered in their favorite color!

Once they arrive, I will be in the office every day to support them in their transition into our practice — whether it’s steering them to the best local specialists with whom we collaborate, discussing a challenging case or just sharing a smile and a laugh. The physical presence of a senior partner helps a new physician grow and thrive in an established medical practice. Other than taking care of the kids I love, my greatest joy in pediatric practice is mentoring younger physicians so they will join me in the true spirit of caregiving at Eugene Pediatrics.

Speaking of “thrive,” we will also welcome Thrive Behavioral Health to the building. Thrive will consist of the practices of Dr. Jenny Mauro and Dr. Katie Ravitch, child psychologists who have tremendous passion for caring for the behavioral and developmental needs of children and families. They will take care of kids from Eugene Pediatrics and the entire Eugene/Springfield area. We couldn’t be more excited for this opportunity to truly integrate medical and psychological care of children in one convenient location.

And save the date! We’re having our Summer Pool Party on Friday, August 22. Once again, Dr. Grieve and I will be hosting our patients and their friends for an evening of fun, splashing at the Amazon Pool and enjoying pizza and Ben and Jerry’s ice cream. Look for more details closer to the event.


140312EPA residentdoctorsMedical training was grueling during my residency nearly 20 years ago. After completing four years of medical school, new MDs routinely worked 110+ hours per week in their area of specialty, for anywhere from three to 13 years. It was not unusual to work stretches of 30-40 hours in a row without sleep. Three times after a work shift of 35 or more hours, I fell asleep at the wheel on my way home from the hospital and rear-ended someone. (Thankfully, nobody was ever hurt.)

When working, the combination of adrenaline and caffeine kept me sharp, and I never felt that my care of sick kids was ever less than the best I could give. In every situation during residency, I was working in a team of physicians at many levels of training, and we constantly provided checks on each other’s thinking. Medical students with years less experience than myself, other residents of roughly my training level and fellows and very senior attending-level doctors with decades of experience worked together on every child’s case.

The goal of the residency years was to teach me everything I would need to be a safe, effective and knowledgeable pediatrician able to function independently at the end of my training. It was an incredible experience, and I would have changed none of it (except for those three fender-bender moments).

140303EPA vaccinationblogA front page article Friday in The Register-Guard highlighted a new law that went into effect March 1 requiring all children who attend school either be vaccinated or have a parent produce evidence that they have been educated about vaccines and still chose not to vaccinate.

Proof of exemption can include a form signed by your child’s physician and a certificate obtained by watching an online education module produced by the State of Oregon about vaccines.

Here is some information I want to share on the new vaccine exemption process:

  • Your pediatricians at Eugene Pediatric Associates believe strongly that vaccinating kids saves lives. We have all seen firsthand the impact of vaccine-preventable diseases on kids. Dr. B vaccinated her own precious children based on many years of experience and confidence in the safety and efficacy of childhood shots.
  • We welcome your questions about shots during your visits at Eugene Pediatrics. You can also read information on vaccines on our website under both the Vaccines and the Resources sections.