Do your state Medicaid preventive care benefits align with Bright Futures?
TrishaKorioth, Staff Writer
For Your Information
New AAP profiles offer a chance to see how your state Medicaid preventive care benefits
compare to the nation’s gold standard of pediatric care, Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition.
Pediatricians and AAP chapters can reference details on the inner workings of each
state Medicaid program’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
When state EPSDT periodicity schedules align with Bright Futures, states ensure theory-based and evidence-driven guidance for all preventive care
screenings and health supervision visits through age 21.
Review your state EPSDT profile, noting whether the EPSDT benefit matches the Bright Futuresperiodicity schedule.
Check your state’s definition of medical necessity against the definition outlined
in the AAP policy. If your state defines medical necessity differently, it might affect what services
are covered by your state’s Medicaid program.
Find out how your state is performing related to pediatric preventive care quality.
Some states voluntarily report performance on Child Core Set quality measures. For
example, your state might perform well in primary care visits with adolescents, but
the adolescent immunization and dental screening rates need improvement.
The Bright Futures national health promotion and prevention initiative is led by the AAP and supported
by the Maternal and Child Health Bureau, Health Resources and Services Administration.
State EPSDT profiles were reviewed by Medicaid EPSDT officials for accuracy when possible.