Waiting for the next shoe to drop: healthcare reform and academic pediatrics.

ealthcare in the US is in the midst of dramatic reform driven by unsustainable healthcare costs. To maintain the traditional missions of clinical care, research, and education, academic pediatric departments must plan for change. Yet, planning is difficult because along with declining clinical revenue there is an increasing burden of chronic disease, a changing workforce, and decreasing Federal research support. A team from the Department of Pediatrics and Primary Children’s Medical Center addressed these issues using a planning process to establish a likely scenario, and developed a strategic plan and tactics to deliver high value pediatric healthcare while maintaining economic stability. We share these planning and operating models to give other academic pediatric departments and children’s hospitals the perspective of one approach to address a rapidly changing healthcare environment.