Multi-Channel Outreaches Increase EPSDT Compliance

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services are required for Medicaid enrollees under 21 years old. They are a vital component of a comprehensive set of benefits designed to assess a child's health at regular intervals and identify potential problems early on. EPSDT, or well-child, visits provide an opportunity for families to ask questions, become educated on healthy behaviors, and develop a relationship with their child's doctor. This is also a time when immunizations are administered, physical and behavioral development are assessed, and important health screenings, such as the lead toxicity screening, are done.

Eliza knows that healthy children are more likely to grow into healthy adults, and that preventive care is the key to raising a healthy generation. We work with Medicaid plans across the U.S. to educate members about the importance of preventive care, remind parents that their child, or children, are due for a well-child visit, and even help them find a primary care provider and set up appointments, should they need a little extra help navigating the system.

When conducting a multi-channel outreach for a large Medicaid plan, those reached by Eliza had a 7.9% greater rate of well-child visits than those that weren't reached. We also consistently see an incremental lift in rates for each additional touch point. In this particular program, members who received a phone call and an email had a 6.2% greater rate of well-child visits, than those who only received a phone call.

Well Child HEDIS RATES

Eliza conducted similar outreaches for members who, according to claims data, received their well-child visits the year before, and were therefore, considered to be compliant. We ran a lighter-touch campaign for this group consisting of a brief phone call and follow-up text message reminding parents and guardians that their child was due for their well-child visit. Those that were reached over the phone had a 6.5% greater rate of well-child visits than those that weren’t reached. There was an additional 2% lift in rates for those who received a text reminder following the call. Multi-channel outreach yields results.

Well Child HEDIS Rates for 'Remind' Group

Not only did Eliza increase the number of children who received important preventive and ongoing care, Eliza also connected families to medical and community resources, an essential component of supporting traditionally underserved populations.

For more information on how Eliza can help you increase EPSDT compliance among your Medicaid members, email us at eliza@hms.com, or call us at 1.844.343.1441.

Jennifer Forster joined Eliza in the summer of 2014 as the Director of Medicaid Strategy. Before Eliza, Jennifer was at Network Health, a Medicaid Managed Care Organization (MCO) and division of Tufts Health Plan. She served as the key operational and product contact with state and federal agencies and managed staff to support contract management activities such as compliance, reporting, communications, and negotiations.

Jennifer attended Syracuse University where she earned a B.S. in Marketing from the Whitman School of Management and a Masters in Public Administration from the Maxwell School of Citizenship and Public Affairs.

 

Add new comment

Image CAPTCHA
Let's Connect