Child Health and Development Services in Medicaid Managed Care Organizations

Objective: We explored the current state of developmental screens, child development services, mechanisms to fund screens and services, and incentives for adopting new services within managed care organizations serving Medicaid enrolees.

Design: National, cross-sectional mail survey. Survey of 388 Medicaid managed care organizations (MMCO) enrolling children in 1998–99.

Results: Most of the 155 plans that responded provided an array of developmental screenings and services, funded primarily through internal mechanisms or under Early and Periodic Screening, Diagnostic and Treatment (EPSDT) programs. Plan contacts expressed interest in implementing new services, particularly if additional funding was available. The most important motivators included requiring services in the Medicaid contract, enhanced capitation rates, and demonstration that providing child development services would reduce other utilization costs.

Conclusions: If state Medicaid agencies want to enhance the child development services available through health plans, they could initiate steps such as requiring child development services in contracts with plans or providers; revising EPSDT language and engaging in more consistent enforcement; and enhancing capitation rates. More research on effectiveness and benefits of specific developmental screens and services is needed.