Michigans Assuring Better Child Health and Development ABCD Project Suzette BurkittWesolek November

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Michigans Assuring Better Child Health and
Development (ABCD) Project Suzette
Burkitt-WesolekNovember 2008
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ABCD Screening Academy

• 15-month initiative, supported by the
  Commonwealth Fund and National Academy for State
  Health Policy (NASHP)
• Selected states received technical assistance,
  access to on-line resource center, opportunities
  to exchange expertise
• Project goal
• Promote use of objective developmental screening
  tool as part of well-child care

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Michigans ABCD Project

• Target population children ages 0-3 years
• 9 pilot pediatric practices
• Primary care providers chose from a list of
  validated standardized developmental screening
  tools
• All practices have implemented standardized
  developmental screening as of 12/1/07

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ABCD Interventions

• Assist practices with obtaining standardized
  developmental screening tools
• Collaborative learning
• Pilot practice technical assistance
• Medicaid policy revision
• Address billing issues
• Communicate information regarding community
  resources (e.g. community partners meeting)
• Part C/Early On training sessions.

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Medicaid Policy Improvement

• Medicaid policy changes include
• List of recommended validated standardized
  screening tools in the EPSDT Policy
• Recommended use of approved guidelines and
  minimal screening standards based on AAP policy
  and Bright Future Guidelines
• Clarification of Medicaid billing process for
  developmental screening (i.e., coding and
  reimbursement) in the form of a provider letter.

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Measurement/Evaluation

• Medical record review
• Target Population Children ages 3-36 months with
  gt 1 well child visit
• Measurement Indicator Standardized developmental
  screening conducted at WC visit at 9, 18, and 24
  or 30 months of age
• Data collection medical record review at
  baseline and 3 6 months post-implementation for
  the following age categories
• 8 - 11 months
• 15 21 months
• 24 - 33 months
• Screening rates include children screened with
  standardized tool children with abnormal
  result children with evidence of referral.
  Rates will be reported in aggregate and by
  practice.
• Provider survey/focus group was conducted in May
  of 2008
• Member survey (3-5 questions in postcard format)
  conducted in June 2008

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Aggregate Medical Record Findings
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Parent Survey
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Parent Survey Results
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Provider Guided Discussion

• Barriers in the practices internal planning and
  implementation procedures
• Billing and reimbursement
• Overall lack of knowledge regarding community
  resources and referral processes Follow-up
  (timely assessment and evidence of communication
  from Early On agencies) is inconsistent
• Appreciated implementing AAP guidelines
  utilizing validated developmental screening and
  improvement in appropriate referrals
• Improved communication with parents
• Thought project was valuable especially this type
  of QI project and the networking with colleagues
  and health care providers
• Gestalt about rethinking well child care,
  proactively focusing on behavioral/developmental
  issues

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Report Recommendations

• Create a toolkit to assist practices with the
  implementation process
• Design standardized developmental screening
  training and CME opportunities
• Continue spread of developmental screening among
  provider practices
• Provide continued networking with local community
  agencies (e.g., Early On Michigan)
• Continue to look at statewide referral capacity

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ABCD Spread Strategy

• Spread within pilot sites
• Regionally, community stakeholders to
• expand local partnerships
• assess and create referral capacity
• create public awareness at the community level
• identify opportunities for networking and ongoing
  communication
• Statewide efforts include
• dissemination of pediatric preventive care
  guidelines
• clarifying and revising policy
• promoting consistency in payment, billing and
  coding

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ABCD Stakeholders

• ABCD stakeholder organizations to
• promote developmental screening using existing
  communication mechanisms meetings, written
  communication, web sites
• participate in regional and statewide efforts
• Stakeholders will continue to meet after the
  conclusion of the formal project to sustain
  momentum and increase developmental screening
  rates.

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Questions?Contact InformationSuzette
Burkitt-Wesolek, BSN, RNABCD Project
ManagerSuzette.Burkitt-Wesolek_at_hc.msu.edu
517-432-1701