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Molina Healthcare of Michigan

  Sent a letter to mothers of newborns in Kent County in their welcome packet asking

them to call Member Services and select a primary care provider as soon as possible.

If the mother selected a provider site that was participating in the pilot project, she

was sent the program materials. 

To identify expectant mothers, a Maternal Child Nurse was hired in August 2003 to

implement a new program (M.O.M.  Moms of Molina) to identify and provide educa 

tional information to pregnant members.  

Results: 

Through these efforts, Molina identified 1,537 children, birth to age three, who were

eligible for the pilot program in Kent County. In addition, Molina increased identifica 

tion of expectant mothers from 33 percent at the beginning of the pilot period to

more than 90 percent by August of 2004.   

STRATIFICATION 

Molina set a goal to identify 100 percent of children, from birth to age three, who had

no EPSDT visits or only one EPSDT visit. The EPSDT database used claims data to

automatically stratify and identify children in need of EPSDT services. 

Aim:

Stratify 100 percent of children in Kent County identified by claims data as either hav 

ing at least one EPSDT visit or having no EPSDT visits.

Measure:

# of children in the Kent County pilot with at least one EPSDT visit

Total # of children in Kent County

# of children in the Kent County pilot with no EPSDT visit

Total # of children in Kent County

Change:

To stratify children, from birth to age three, Molina developed a database of children

needing an EPSDT screen. The database was updated monthly by Education

Department staff. 

Results: 

During the initial pilot phase, from July 2003 to November 2003, Molina increased the

identification of children with at least one EPSDT visit from 46 percent to 72 percent. 

Stratification                                  July 2003                      Nov 2003

# of children with EPSDT visit

527 = 46.3%                    624 = 72.3%

Total number of children

1,137

862

# of children with no EPSDT visit

610 = 53.6%

238 = 27.6%

Total number of children

1,137

862                       

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