Trends in the Use of EPSDT and Other Health Care Services by Children Under Medicaid, 1989 and 1992. Year 2 Report

摘要

EPSDT was added to the Medicaid program in 1967 by P.L. 90-248 to provide screening and preventive care, as well as referral for services necessary to correct health problems identified through screening. Because of concerns over low EPSDT participation rates among both beneficiaries and providers, Congress passed sections of OBRA-89 that set standards for performance at the State level, created incentives for greater provider participation and broadened the scope of services covered. The report provides a descriptive analysis of the extent to which preventive care services are being provided to children under the Medicaid program, focusing on the effects of OBRA-89 on the success of four State Medicaid EPSDT programs (CA, GA, MI, TN) in reaching and screening poor children. A methodology for measuring EPSDT participation and adherence to screening guideline that takes into account age and Medicaid enrollment duration was developed. Data on diagnosis and treatment services were also analyzed. Between 1989 and 1992, there were slight, to moderate, improvements in the proportion of Medicaid enrolled children receiving at least one screening visit and in the number of recommended visits in three of the States; CA remained the same. These improvements occurred during a period of marked increase in child enrollment in Medicaid, increasing by 42 to 66 percent between 1989 and 1992 in GA, CA and TN, but stable in MI.