visits. In addition to contacting members, Molina developed educational materials

for provider offices that explained the components of an EPSDT exam, additional

services required for Medicaid beneficiaries, proper CPT codes, billing instructions,

referral sources for children with developmental delays, and plan contact numbers.

Providers were appreciative and extremely supportive of Molina's efforts to get chil 

dren in for well child visits.

55

DC Chartered

DC Chartered Health Plan worked with two high volume provider sites to imple 

ment consistent use of ASQ as a screening tool for plan members. DC Chartered

staff trained provider office staff on using ASQ, and worked with the sites to imple 

ment additional office system changes.  These included color coding for age specific

forms, providing information about how the forms are scored, and working with the

clinic to assure appropriate referral and follow up for children identified at risk.

After the questionnaires were completed, the health plan scored each one and pro 

vided follow up information to providers and parents.

Four months into the pilot, 275 children born between April 1, 2000 April 1, 2001,

were seen at two high volume provider sites for well child visits.  Out of the 275

children, 175 ASQs were completed during these visits (64 percent).  None of these

children were previously screened for developmental delay. Thirteen children out of

175 (seven percent) were identified as at risk; five of the 175 (three percent) were

referred for a developmental evaluation. A developmental milestone chart and infor 

mation about available resources were mailed to the remaining eight families. DC

Chartered has continued this program beyond the conclusion of this workgroup.

CommunityCARE

Louisiana's EPSDT Program, KIDMED, developed standardized flowsheets

56

to help

guide EPSDT visits at each age interval. The flowsheets were introduced at

CommunityCARE's annual provider training. Each flowsheet includes sections on

developmental assessment and anticipatory guidance. These forms help providers

remember what preventive and child development services should be covered at

each KIDMED visit. Most CommunityCARE providers are using the flowsheets and

report positive feedback. In particular, providers appreciate that the flowsheets are

comprehensive as well as user friendly. Many providers use the form for all of the

patients in their practice, not just those who are eligible for the KIDMED program.

The standardization across the state has been useful for chart monitoring and perfor 

mance evaluation.

Health Plus 

Health Plus set a goal to increase well visits (including developmental assessments)

by 20 percent in members 0 4 years.  The plan identified select ICD 9 codes from

claims data to identify 563 children, age 0 4, at risk for developmental delays.

57

The

health plan sent letters to providers notifying them of high risk members and offered

instructions on office based screening (Figure 6). By identifying children for

providers, Health Plus was able to reduce provider site administrative burden.

Health Plus' pilot resulted in a 26 percent increase in developmental screening

55 

For more information about Molina's member outreach, see pages 25 and 47.

56

CommunityCARE's documentation flowsheet is available in the online toolkit at www.chcs.org.

57

The ICHAP ICD 9 list is available in the online toolkit at www.chcs.org.

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