Encouraging care for parents and guardians of your CHIP patients

September 28, 2020

Independence has developed a series of messages for the parents and/or guardians of our Children’s Health Insurance Program (CHIP) members to help families manage their child’s health care. The topics chosen are based on Healthcare Effectiveness Data and Information Set (HEDIS®) measures. We are sharing these topics with you in an effort to help support compliance with these measures and to encourage families to obtain these important services.

This month’s message is about the importance of scheduling well-child visits.

HEDIS definition

Well-child visits should include: a physical exam, health history, physical developmental history, mental developmental history, and health education/anticipatory guidance. The visits should occur at the following intervals:

  • Well-child visits in the first 15 months of life. Children who turned 15 months of age should have six or more well-child visits.
  • Well-child visits for 15 – 30 months of life. Children who turned 30 months old should have two or more well-child visits.
  • Well-child visits in the 3rd, 4th, 5th, and 6th years of life. Children ages 3 to 6 have at least one well-child visit with their primary care physician (PCP) annually.
  • Adolescent well-care visits. Members ages 12 to 21 should have at least one well-care visit with a PCP or OB/GYN (for example, school physical, Pap test, postpartum visit) annually.

How you can help

Follow the tips below to ensure patients get the care they need:

  • For newborn and infant patients, schedule the entire suite of visits at the conclusion of the first visit.
  • Inform caregivers of the importance of well-child visits.
  • Make outreach calls to members who are not on track to complete the recommended visits.
  • Keep an active tracking system to monitor yearly visits for each member.
  • Perform developmental surveillance at each well-child visit and document the use of a standardized developmental screening tool at 9 months, 18 months, and 30 months of age, or when surveillance yields concern in your chart and in a claim. Examples of Validated Screening Tools for developmental delays can be found on the Bright Futures website for the ages below:
  • Refer children who have been identified with a suspected developmental delay to one of the early intervention agencies listed in the resources section of our website.

Learn more

Visit the American Academy of Pediatrics and Bright Futures website for comprehensive guidelines and recommendations regarding well-child visits.

Stay tuned for more topics regarding care for your CHIP patients.