Feb 1, 2021

Pediatric Population Health Addresses Children’s Ages And Stages

Population health is a way to describe a focus on disease prevention and the management of chronic diseases in order to prevent the use of emergency or inpatient care. It focuses on the promotion of healthy habits, and on an environment that supports the health and well-being of a population. But is a population health approach really needed for children? Consider the following trends.

According to the Centers for Disease Control (CDC), nearly one in five children in the United States has a special healthcare need. One in 12 children has asthma and 1.2 million children have elevated lead levels. Even low levels of lead in the blood have been shown to affect IQ, ability to pay attention and academic achievement.

Obesity rightly receives a lot of attention. The CDC noted in 2016 that 18.4 percent of children aged 6–11 years and 20.6 percent of adolescents aged 12–19 years were obese. As they advance in age, their health concerns evolve. For example, screening for substance use becomes critical since smoking (3 percent) and alcohol use (9.9 percent) start to become more common for young people between 12–17 years of age. On top of these health concerns, children may lack access to healthcare or fall behind on receiving routine health visits. Additionally, they may have socioeconomic and environmental issues where they live; particularly if they are around smokers or are continually exposed to mold, dust and pollen. These children might not be going to their primary care visits and they may not take advantage of preventive actions like getting a flu shot every year.

Interventions And Milestones

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a federal initiative aimed at addressing the health needs of children. The American Academy of Pediatrics maintains a list of required and recommended interventions and updates them annually. The EPSDT schedule is a complex set of appointments aimed at assessing key developmental milestones, screening and diagnosing health issues, and providing recommended vaccinations within the child population. EPSDT visits help identify emerging health concerns in children that may lower overall costs.

Current federal rules require states to implement quality oversight and reporting specifically through the EPSDT program for quality-of-care oversight. This governs managed care organizations and provides rules for monitoring Children’s Health Insurance Program (CHIP) plans. State Medicaid agencies are required to report annually on EPSDT services delivered to all eligible children (submitted on Form 416 to the federal government). Many state Medicaid programs require specific monitoring for lead screening and adherence to the immunization schedule. EPSDT monitoring assists health plans striving for compliance with numerous HEDIS measures:

  • Well-child visits in the first 15 months of life (W15)
  • Well-child visits in the third, fourth, fifth and sixth years of life (W34)
  • Adolescent well-care visits (AWC)
  • Weight assessment and counseling for nutrition and physical activity for children/adolescents (WCC)
  • Childhood immunization status (CIS)
  • Immunizations for adolescents (IMA)
  • Lead screening in children (LSC)
  • Child and adolescent access to primary care practitioners (CAP)
  • Annual dental visit for children (ADV)

Help For Health Plans

Altruista Health recently unveiled its GuidingCare® Pediatric Population Health feature, with a focus on EPSDT screenings and services, including dental, as well as immunization schedules. Read more.