Section 5

Primary care practitioners play an especially important role in the early identification

Working

and referral of children with developmental delays under three years of age. The

National Survey of Early Childhood Health shows that 95 percent of young children

with

between four months of age to their third birthday had a doctor's visit in the last 12

months.

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Physicians who care for infants and toddlers are in a unique position to

Providers

observe developmental progress, identify children with developmental problems,

counsel parents on developmental issues, and make appropriate referrals for children

requiring intervention.

Health plans can work with providers to help reduce administrative burden and

improve workflow; reward quality through incentives; and provide trainings on the

importance of developmental screening and early intervention, new screening tools,

community resources, and efficient navigation of the reimbursement process. The

health plan participants in the BCAP Workgroup on Enhancing Child Development

Services in Medicaid Managed Care implemented several provider strategies to improve

child development services. 

Reducing Administrative Burden and Improving Workflow

Health plans can reduce administrative burden on provider practices by providing

tools for, and potentially administering and scoring, standardized developmental

screens. Health plans can also improve workflow by providing critical utilization

data to providers. For example, health

plans can use reminder systems to

encourage the use of preventive ser 

 Molina s efforts brought a lot

vices, or provide feedback to physicians

more children to us for well child

on utilization to encourage better pro 

exams, particularly the two  to

cesses of care. Following are examples

three year olds. It really took a lot

of how participants in the BCAP

of the work from us in not having

Workgroup supported their providers.

to contact people ourselves.

Seeing these kids on a more timely

Missouri Care

basis obviously helps us to identify

Missouri Care aimed to implement use

problems early and reduce poten 

of the ASQ screener and increase the

tial aggravations of problems. 

percentage of 18 26 month old chil 

 Gary Detwiler, Physician Assistant at 

dren receiving developmental screening

Sparta Health Center in Sparta, Michigan

to 80 percent at pilot clinics. Clinic

staff identified Missouri Care members presenting for a 24 month EPSDT check up.

Parents were encouraged to complete the ASQ while in the waiting room. Nurses

scored the completed ASQs and tracked the referrals made to specialty care for fol 

low up. From June to August 2004, 85 ASQs were handed out to parents presenting

with their children for a 24 month EPSDT visit, 36 ASQs were completed, and five

children were referred to specialty care.

Molina Healthcare of Michigan

Molina was able to reduce administrative burden at its provider sites by implement 

ing a regular system for contacting members through outreach mailings, which 

significantly increased the number of children visiting the pilot site for well child 

54

L. M. Olson, M. Inkelas, N. Halfon, M.A. Schuster, K.G. O Connor and R. Mistry,  Overview of the Content of Health Supervision for Young Children: 

Reports From Parents and Pediatricians,  Pediatrics 113, no. 6 , Suppl., (2004):1907 1916.

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