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Molina Healthcare of Michigan

MEMBER EDUCATION

Molina developed an age specific educational mailing for parents that explained the

components of the EPSDT exam, provided health tips and milestones, and offered the

incentive of a baby board book for members who scheduled well child visits. The mail 

ing included a tear off form for members to take to the provider's office. During the

visit the provider office completed the form, indicating services rendered, develop 

mental screening performed, tests performed, and referral(s) made, and sent it to

Molina. Upon receipt of the form, Molina sent a board book as a gift to parents for

their child. Between July through December 2003, 833 books were mailed.

PROVIDER EDUCATION

Molina developed educational materials for provider offices on EPSDT components,

coding, and referral sources for children with developmental delays. Providers received

the following laminated sheets:

Overview that explains components of EPSDT exam, additional services required for

Medicaid recipients, proper CPT codes, billing instructions, referral sources for chil 

dren with developmental delays, program outline, and plan contact numbers.

List of CPT codes to bill for the EPSDT exam.

EPSDT schedule of services.

Summary of developmental assessment tools, including information on the specificity

and sensitivity of the tool, the age groups covered by the tool, a description of the

tool, the cost, length of time to complete, and where to purchase the tool.

Molina worked with the Kent County Health Department to develop a list of area orga 

nizations that provide services to children with developmental delays. Each pilot site

was given information on area referral sources. Molina found that some of the offices

were not aware of or were not familiar with other referral sources that address the

needs of children under the age of three. All offices were provided with contact infor 

mation and a summary of the services available for children three and under.

OVERALL PROGRAM RESULTS

At the end of the six month pilot program, Molina's EPSDT rate for children from birth

to age three increased from 46 percent to 76 percent. Twelve children (5.6 percent)

were identified through developmental screening and were referred for follow up inter 

vention. Additionally, the EPSDT exam rate for three year olds rose from 46 percent to

63 percent. 

SUSTAINING AND DIFFUSING THE PROGRAM

Based on its success in increasing EPSDT rates, the  Baby Steps Towards Health 

Program was incorporated into Molina's existing statewide EPSDT reminder program.

As of February 2004, children from birth to age three (13,000 members) due for an

EPSDT visit are mailed a Well Child Visit Sheet providing age specific information

about the components of the EPSDT visit, information about any immunizations/tests

due, and developmental milestones. In the mailing, parents are asked to schedule an

appointment and bring a list of their questions or concerns to the well child visit. Visit

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