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Office-based education about developmental screening prompts higher use of validated tools, added reimbursement

Wednesday, October 15 2008 | Comments
Evidence Grade 7 What's This?
By Yvonne Poindexter

A new program that provides office-based education emphasizing early child development appears to increase pediatricians' use of important developmental screening tools in young children, according to new data presented by Dr. Mark Rosenberg, assistant professor of pediatrics at Northwestern University's Feinberg School of Medicine.

An American Academy of Pediatrics policy statement in 2006 asked community pediatricians to use developmental screening tools as part of the preventive care of young children, since use of the tools plus the observations of practitioners and the child's family provide a better approach to the social and emotional needs of children, explained Dr. Rosenberg. Because the use of validated screening tools represents a significant change from the surveillance that has typically occurred at well-child visits, such tools are still underused, he said.

To test an intervention designed to promote the use of such screening tools, the Illinois Chapter of the AAP developed a new program called Enhancing Developmentally Oriented Primary Care (EDOPC). The program's goal was to educate physicians in their offices about the use of developmental screening tools, including information regarding reimbursement for such services. A panel of developmental pediatricians and community physicians designed the curriculum, which emphasized early child development and included the use of developmental screening tools, maternal postpartum depression screening, and early identification of autism spectrum disorder.

From the EDOPC roll-out in 2005 through 2007, the number of Illinois providers that billed Medicaid for the use of a developmental screening tool increased 66%, increasing from 299 at baseline to 496. The number of patients screened rose from 14,968 in 2004 to 95,805 at the end of 2007, a more than 5-fold increase.

As a result of the added screening, the number of children referred to the Early Intervention program in Illinois, which provides aid for children with disabilities or developmental delays, has increased 4-fold for children aged 1 to 3 years. In addition, the number of women completing a perinatal maternal depression screening has grown 5-fold.

"The success of the program is attributed to an effective curriculum based in an office setting to all of the staff members and physician payment," Dr. Rosenberg concluded.

The program's developers are working to extend the program to other health care payers.

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