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Fulfilling the Promise:
How States Invest in Early Childhood Development under Medicaid and SCHIP

Funded by
The Commonwealth Fund
New York, NY
www.cmwf.org

The overarching goal of this project is to support the Commonwealth Fund's mission of improving the quality of early childhood development for all children. This goal was accomplished through an in-depth, nationwide analysis of how states implement the promise of comprehensive prventive pediatric coverage in early childhood development under their Medicaid and SCHIP programs and an assessment of how well state payment arrangements conform with Medicaid Early and Periodic Screening Diagnosis and Treatment (EPSDT) standards and SCHIP coverage standards, as well as other standards with which state programs must conform, such as the standard electronic claims coding system that has been developed for HIPAA and that has been in place since Fall 2003. This analysis and assessment resulted in the development of a comprehensive 50-state manual that allows a comparative examinatio of state approaches to prevenive child health coverage implementation as well as a description of the range of possible approaches to clinical standards of care in early childhood development.

Individual State Profiles
(Medicaid and SCHIP)

50 State Comparisons (Medicaid Only)

Periodicity Schedules

State Preventive Visit Periodicity Schedules

Separate Vision, Hearing, Dental Schedules

Recognized Billing Codes

Overview and Summary of Findings
(Medicaid and SCHIP)

Markus A et al. (2005) Fulfilling the Promise: How States Invest in Child Development Under Medicaid and SCHIP: A 50-State Compendium of Coverage and Payment Policies of Preventive Pediatric Care: Overview. Washington, DC: The George Washington University, School of Public Health and Health Services, Department of Health Policy.

[LINK TO REPORT]

Markus A "A Nationwide Study of State Coverage and Payment Policies of Preventive and Developmental Services for Young Children" Fulfilling the Promise: How States Invest in Child Development under Medicaid and SCHIP. Association of Maternal and Child Health Programs 2006 Annual Conference. Crystal City, VA: March 8, 2006.

Markus A " Medicaid & SCHIP Coverage and Payment Policies for Children -- Are We Fulfilling the Evidence-Based Promise of Improved Preventive Child Health Care?" The Evidence Base for Medicaid's Maternal and Child Health Services Martha May Eliot Forum American Public Health Association, 133rd Annual Meeting & Exposition, Philadelphia, PA: December 13, 2005

Payment of Child Developmental Services under HIPAA
(Medicaid Only)

Markus A, Rosenbaum S, Stewart A et al. (2005) "How Medical Claims Simplification Can Impede Delivery of Child Developmental Services" New York, NY: The Commonwealth Fund. Available at: http://www.cmwf.org/publications/publications_show.htm?doc_id=290754 http://www.cmwf.org/usr_doc/Medical_Claims_Simplification.pdf

Tools (In Progress)

Preliminary Cross-Walk between Coverage and Payment of Preventive and Developmental Services

Other Publications/Presentations of Interest

The Commonwealth Fund. (2005) EPSDT: An Overview. New York, NY
http://www.cmwf.org/publications/publications_show.htm?doc_id=358313
http://www.cmwf.org/usr_doc/893_EPSDT_overview.pdf

The Commonwealth Fund. (2005) Comparing EPSDT and Commercial Insurance Benefits. New York: NY
http://www.cmwf.org/publications/publications_show.htm?doc_id=358345

http://www.cmwf.org/usr_doc/895_comparing_EPSDT_commercial_ins_benefits.pdf

The Commonwealth Fund. (2005) How Medicaid and EPSDT Promote Healthy Child Development Among Children with Special Health Care Needs. New York: NY
http://www.cmwf.org/publications/publications_show.htm?doc_id=358334
http://www.cmwf.org/usr_doc/894_how_Medicaid_EPSDT_promote_healthy_child_devel.pdf

The Commonwealth Fund. (2005) EPSDT and Children's Coverage Costs. New York: NY
http://www.cmwf.org/publications/publications_show.htm?doc_id=358425
http://www.cmwf.org/usr_doc/896_EPSDT_childrens_coverage_costs.pdf

Rosenbaum S. "Medicaid EPSDT Benefits: Their Role in Child Health and Development." Health Services For Children: The Role of Medicaid and Its Benefit Package Alliance for Health Reform Briefing Washington, DC: September 9, 2005.

Rosenbaum S, Proser M, Sonosky C. (2001) Health Policy and Early Child Development: An Overview. New York, NY: The Commonwealth Fund
http://www.cmwf.org/usr_doc/rosenbaum_early_450.pdf

Rosenbaum S, Proser M, Schneider A et al. (2001) Room to Grow: Promoting Child Development Through Medicaid and CHIP. New York, NY: The Commonwealth Fund
http://www.cmwf.org/usr_doc/rosenbaum_room_451.pdf

Rosenbaum S, Proser M, Schneider A et al. (2002) Using the Title V Maternal and Child Health Services Block Grant to Support Child Development Services. New York, NY: The Commonwealth Fund
http://www.cmwf.org/usr_doc/rosenbaum_titlev_481.pdf

Rosenbaum S, Proser M, Shin P et al. (2002) Child Development Programs in Community Health Centers. New York, NY: The Commonwealth Fund
http://www.cmwf.org/usr_doc/rosenbaum_chcs_480.pdf