Doderer Enlists as Youths Face Mental Crisis

Marcy Doderer, CEO of Arkansas Children’s

Children’s hospitals across the country are seeing a new crisis during the pandemic: an increasing number of teenagers with mental and behavioral health issues.

Marcy Doderer, the president and CEO of Arkansas Children’s, will be working on that matter as well as on the financial struggles of children’s hospitals as chair of the board of trustees of the Children’s Hospital Association, a role she started on Jan. 1. The CHA is a national organization that represents about 200 children’s hospitals and advocates for child health at the federal level.

“Marcy brings her long experience in pediatric health care to this leadership role at a crucial time for children and children’s hospitals nationwide,” Mark Wietecha, CEO of the CHA, said in a news release.

The CHA will seek more federal funds for mental, emotional and behavioral health services for children, as the need has increased during the pandemic, Doderer said.

“I hear from my colleagues across the country of how many children are needing inpatient psychiatric facilities and the beds are just not available,” she said. “Anecdotally, it’s definitely being viewed as another epidemic within the pandemic.”

Researchers are gathering data on the pandemic’s impact on children’s health, and what the near, mid- and long-term effects will be on social isolation and virtual learning.

Arkansas Children’s, which has two hospitals in its system, also is seeing an increase in the number of children needing those services, “and how difficult it can be to find appropriate placement in behavioral health settings for those kids,” Doderer said.

Arkansas Children’s offers pediatric psychiatry services through the University of Arkansas for Medical Sciences in Little Rock. Arkansas Children’s is seeking donors to develop a pilot program that would look at how a child’s early use of mental health providers could avoid a behavioral health crisis later. Arkansas Children’s doesn’t have a dollar amount that it is seeking, but it plans to demonstrate early results and expand the program with other funds.

Meanwhile, children’s hospitals also are facing lower revenues as the number of patient visits has fallen.

While some hospitals that treat adults have seen their patient volumes increase during the pandemic, that hasn’t been the case for children’s hospitals, as there haven’t been as many children impacted by COVID-19 as adults. “And with kids practicing social distancing and mask-wearing and handwashing, we’re not seeing all the winter viral illnesses that we usually see,” Doderer said.

Children’s hospitals around the country generally have seen a drop of about 30% in inpatient visits and of about 15% in admissions, she said. Surgeries are also down about 10%, which has resulted in a revenue decline of about 5% from pre-pandemic levels.

Arkansas Children’s had operating revenue of $724.4 million for its fiscal year that ended June 30, a 3% increase from the previous year. Its operating income for the year was $28.9 million, a decrease of 6.8% from the previous year.

Doderer said Arkansas Children’s had a strong financial performance and growth until the middle of March. Then it suffered “the steep decline” in patient volumes until June. The nonprofit hospital system’s current fiscal year has been solid, but “not nearly as strong” as the previous fiscal year, she said.

The Children’s Hospital Association also will be focused on preserving Medicaid funding for children’s hospitals. Of the 80 million children in the country, “almost half of them require some level of Medicaid support in their states,” Doderer said. “And that revenue source and insurance coverage source for kids is incredibly important.”

Doderer said children’s hospitals may never see the patient volume levels in the emergency departments that they did prior to the pandemic. She thinks more parents will use telemedicine services or outpatient services from now on for minor issues. That trend is already evident in Arkansas. In 2019, Arkansas Children’s had 360 telehealth visits. In 2020, the number jumped to 6,780.

“I think the shift to telehealth and telemedicine and outpatient services is something that we’ll continue to build upon,” Doderer said. “I think that will be forever changed in health care.”