Director Toinette Laguerre says since the onset of the pandemic, operational costs have gone up 13%, the cost of assessment tools required to evaluate children has gone up 31% and the medical billing software cost has increased by 28%.

“It’s very difficult for business owners to continue to keep operating costs down,” Laguerre said. “We are regulated by insurance companies and by our government contracts as far as the revenue we can actually bring in as a company.”

Laguerre says unlike a retail or food business, they cannot simply increase their prices. Taking on more patients to offset the cost is also not an option, since they are running at full capacity with the number of therapists they have. Laquerre says the business services 500 appointments a week.

Another factor contributing to the increasing costs is insurance companies reducing the amount of money they reimburse companies. Medicaid, for example, reimbursed health care providers 5% more in 2020 for assistance during the peak of COVID, but that has since been taken away.

Pediatric Boulevard started as a travel therapy business before Laguerre moved to the building Pediatric Boulevard is now.

“Since I started the traveling therapy company back in 2006, the Medicaid rates have decreased by 11% for therapy services,” Laguerre said.

Pediatric Boulevard still offers to provide care to children at their home or daycare if there is an accessibility issue and the family can’t get to Pediatric Boulevard’s building. Laguerre says in the past week, two separate insurance companies have told her the company will no longer cover therapy services that are not provided inside the clinic.

“This is a problem for families that work during the day and are unable to get the children to the clinic for treatment. Unfortunately, we are going to have to discontinue services for those kids,” Laguerre said.

Laguerre says there isn’t an opportunity to negotiate rates with insurance companies as a small business.

“It’s more difficult to have a reimbursement rate that’s equivalent to the level of experience that the therapist has or the services that we are providing. So, oftentimes, more companies will try to see more children in order to offset that, but it’s difficult with staff shortages.”

She has seen colleagues in the business close because running the private practice became too expensive. Laguerre says the waitlist at Pediatric Boulevard is now three to four months long, consisting of children waiting to get help.

“We have some who are unable to eat, unable to walk or talk, and without these services they would not be able to accomplish those goals,” Laguerre said.