These measures are part of the Healthcare Effectiveness Data and Information Set (HEDIS) developed and maintained by the National Committee for Quality Assurance (NCQA) and were widely used by managed care companies before being incorporated into the child core set. Well-child visits are a good proxy for an EPSDT screening because EPSDT screenings are generally conducted as part of a well-child visit. Importantly for monitoring EPSDT, three of the measures in the child core set are related to well-child visits: well-child visits in the first 15 months of life well-child visits in the third, fourth, fifth, and sixth years of life and adolescent well-care (ages 12-21). (For more on the core set and other ways to measure and improve quality in Medicaid and CHIP, see this primer from Tricia Brooks.) The 2016 core set includes 26 measures categorized in seven areas: access to care, preventive care, maternal and perinatal health, behavioral health, care of acute and chronic conditions, oral health, and experience of care. The initial core set has been updated periodically and continues to include a range of children’s quality measures encompassing both physical and mental health. Some data points, like those related to dental, are more likely to be accurate.įollowing the CHIP Reauthorization Act of 2009, CMS finalized an initial core set of 24 children’s health care quality measures for voluntary use and reporting by Medicaid and CHIP programs. For example, each state may select a different periodicity schedule, impacting overall performance and preventing accurate comparisons.Īdvocates should work with their state administrators to determine the reliability of the data. Additionally, while CMS-416 data can be used to monitor a state’s progress over time, it is not a reliable metric to make comparisons across states because the metrics are not standardized. For example, it is unclear if all EPSDT screens are captured accurately, particularly if delivered in a managed care context. Historically, CMS-416 data have been difficult for states to report accurately and although CMS has implemented additional data quality control procedures in recent years, concerns remain. Each data point is reported by age group as follows: under 1 year, 1-2 years, 3-5 years, 6-9 years, 10-14 years, 15-18 years, 19-20 years, and all age groups combined.ĭata from the CMS-416 are available dating back to 1995 and all the way up through 2015, but should be used with caution. The CMS-416 collects 10 basic data points (see text box), with some additional detail on certain topics, like dental. The form collects basic information and can be used to assess the effectiveness of state implementation of the EPSDT benefit that is mandatory in Medicaid and Medicaid-expansion CHIP programs and optional in separate CHIP programs. States are required to use this form to report EPSDT data to CMS annually. The official federal data source for EPSDT is the CMS-416 form. If you missed the first part, go back for a moment to catch up before continuing. To license the Toolkit to use the forms in practice and/or incorporate them into an Electronic Medical Record System, please contact AAP Sales.For the second part of our series on EPSDT, we’ll turn our attention to data. For more detailed information about the Toolkit, visit. Reminder for Health Care Professionals: The Bright Futures Tool and Resource Kit, 2nd Edition is available as an online access product. The 12 additional languages are Arabic, Bengali, Chinese, French, Haitian Creole, Hmong, Korean, Polish, Portuguese, Russian, Somali, and Vietnamese. Beginning at the 7 year visit, there is both a Parent and Patient education handout (in English and Spanish).įor the Bright Futures Parent Handouts for well-child visits up to 2 years of age, translations of 12 additional languages (PDF format) are made possible thanks to the generous support of members, staff, and businesses who donate to the AAP Friends of Children Fund. Each educational handout is available in English and Spanish (in HTML and PDF format). Each educational handout is written in plain language to ensure the information is clear, concise, relevant, and easy to understand. The Bright Futures Parent and Patient Educational Handouts help guide anticipatory guidance and reinforce key messages (organized around the 5 priorities in each visit) for the family.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |