What They’re Watching: Resa Bradeen, MD, Metropolitan Pediatrics

Resa Bradeen, MD, is the Chief Medical Officer at Metropolitan Pediatrics. She joins us in this edition of “What They’re Watching” to discuss transforming financial silos for pediatric care.

“You know in pediatrics, there’s several big areas [that I’m watching], but one of the most important areas we really need to focus on is the ability to de-silo funding and ability to deliver and pay for integrated behavioral health in primary care settings. With children it’s really, really important that we start this really early — all the way from infancy into adolescence. And in very young children, families are not going to take their young children to a specialty mental health service. Certainly there’s problems when you get older with stigmas and wanting to do that, but really in an [age] 0 to 8 space, they don’t belong in a specialty mental health setting. We really should be delivering that care to the whole family in those early ages and getting upstream. And sometimes those diagnoses won’t qualify, certain codes don’t work, and you need to just be able to provide the needed services.

I think the pediatricians are really embracing and seeing the value of having psychologists, social workers, developmental therapists, and other areas within the primary care setting. They’re just really struggling to figure out how to make the nuts-and-bolts work from a financing [standpoint], especially because of the siloed funding streams in the past.

I think we all have to do a lot of education, understanding, self-reflection — and then it begins to make sense, right? We all know from raising our own children, or our nieces or nephews, or our community and schools, that we do have to do things differently. We don’t know exactly how to do this and exactly which things should be happening in the health care office, the education setting, or our community-based settings. So there’s a lot of work in Oregon, and especially in the tri-county area, around kindergarten readiness. And there are health care providers, education providers,  social services, foundations, philanthropic investors, and the business community all coming around the table saying, “we need to change how we’re doing this.” And it’s going to take time, and energy, and pilots, or experimenting, and figuring out how to do it. But if we stay siloed with human services and healthcare and education; if we silo the delivery and we silo the funding, we’re not going to get where we need to be.”