Intensive Preventive Care and Screening in the Medical Home

mother and son

The preventive care visit (well child visit) is important for all children, but it is particularly important for children in low income families (especially children on Medicaid), because the well child visit is when the care can occur that addresses many of the health disparities they experience.  For virtually all of the conditions for which screening is done during well child or adolescent visits, children on Medicaid have the poorest outcomes.  So ensuring children on Medicaid receive all of their well visits, screening, anticipatory guidance, immunizations, and early interventions is crucial.

A medical home is a primary care clinic or practice that provides preventive care as well as care for acute illness and chronic illness, with good access to appointments, health care advice 24 hours a day, and takes responsibility for coordinating care for the child.  There is strong medical evidence, for children covered by Medicaid and CHP+, that receiving regular preventive care in a high functioning medical home significantly improves health outcome and reduces disparities. Click here for more on medical home.

Colorado Medicaid has adopted the recommendations of the American Academy of Pediatrics Periodicity Schedule as the guidelines for providing preventive care at well child and adolescent visits.  Please check the Periodicity Schedule for details of what to include in the visits.  Colorado Medicaid provides reimbursement for many of the screening tests in addition to reimbursement for the visit itself.

Screenings reimbursed by Colorado Medicaid include:

Other activities for which Medicaid provides incentives:

  • Meeting the Medical Home Standards for children on Medicaid
  • Meeting a target percentage of children on Medicaid who have a well child visit during a year
  • Meeting a target rate of children seen in an emergency department

Other important screening:

CCHAP can help

  • CCHAP can help you meet Colorado Medicaid Medical Home Standards and meet targets for incentives
  • CCHAP can assist your practice implement standardized, validated screening tools that lead to early recognition and treatment for common problems.
  • CCHAP can help your practice implement a Quality Improvement project aimed at ensuring you are providing screening to all appropriate children and maximizing your reimbursement.

Contact CCHAP for more information.