urban institute nonprofit social and economic policy research

Improving the Lives of Young Children:

The Role of Developmental Screenings in Medicaid and CHIP

Read complete document: PDF


PrintPrint this page
Share:
Share on Facebook Share on Twitter Share on LinkedIn Share on Digg Share on Reddit
| Email this pageE-mail
Document date: December 14, 2010
Released online: December 20, 2010
Untitled Document

Abstract

Many young children have health, developmental or behavioral problems that are not identified before entering kindergarten, preventing them from receiving early intervention services. Large gaps in early identification exist in Medicaid, the nation’s largest health insurance program for children, in which eligible children are entitled to regular screenings. This brief breaks down the shortfalls in receipt of developmental screenings into: not all eligible children are enrolled in Medicaid/CHIP; not all enrollees see a health care provider; and not all providers have the appropriate skills. To address these problems, states can take a number of steps within the Medicaid/CHIP policy environment.

The text below is an excerpt from the complete document. Read the entire brief in PDF format.


Executive Summary

Many young children have health, developmental or behavioral problems that are not identified before entering kindergarten, preventing them from receiving such services as medical care, early intervention services, or simple equipment like eyeglasses or hearing aids. Yet as health care providers and early childhood providers alike recognize, ensuring that children get the right treatment or services early on can maximize their developmental outcomes, while failing to identify and treat these problems may compromise children's ability to perform to their potential in school and lead to more costly special education and/or health care interventions later. For these reasons, the importance of screening is reflected in both the American Academy of Pediatrics' Bright Futures guidelines and the Head Start Performance Standards.

Yet large gaps in early identification exist in Medicaid, the nation's largest health insurance program for children, in which eligible children are entitled under federal law to get regular health and developmental screenings. In Medicaid, practical implementation challenges result in missed screening and treatment services; CHIP benefits vary by state and do not always offer coverage for these services. Together, Medicaid and CHIP cover half of low-income children and an even larger share of lowincome young children. Increasing developmental surveillance and screening rates in Medicaid and CHIP could greatly increase how often developmental delays are correctly identified in this population.

This brief breaks down the shortfalls in receipt of developmental screenings among low-income children into the following components: not all eligible children are enrolled in Medicaid/CHIP; not all those who are enrolled see a health care provider for well-child visits, and many do not have a regular provider who tracks their care over time; and even when children visit health care providers, not all providers have the appropriate tools or skills to carry out effective developmental screenings. Together, these problems undercut the intent of the law that all Medicaid-covered children should receive screenings.

To address these problems, states can take a number of steps within the Medicaid/CHIP policy environment. To track both gaps and progress in this area, states will need to invest in data systems that allow them to evaluate how rates of Medicaid and CHIP participation, screening, assessments, and referrals are changing. Progress in this area will require investments in health information systems and technology, quality measurement, and public program administration.

End of excerpt. The entire brief is available in PDF format.



Topics/Tags: | Health/Healthcare


Usage and reprints: Most publications may be downloaded free of charge from the web site and may be used and copies made for research, academic, policy or other non-commercial purposes. Proper attribution is required. Posting UI research papers on other websites is permitted subject to prior approval from the Urban Institute—contact publicaffairs@urban.org.

If you are unable to access or print the PDF document please contact us or call the Publications Office at (202) 261-5687.

Disclaimer: The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders. Copyright of the written materials contained within the Urban Institute website is owned or controlled by the Urban Institute.

Email this Page