Preventing disease before it starts is critical to helping people live longer, healthier lives. Medicaid and the Children's Health Insurance Program (CHIP) promote prevention by helping millions of beneficiaries gain access to preventive health care services.
Preventive health care services include immunizations, screenings for common chronic and infectious diseases and cancers, clinical and behavioral interventions to manage chronic disease and reduce associated risks, and counseling to support healthy living and self-management of chronic disease.
CMS is committed to helping states undertake efforts to expand access to preventive health care by providing technical assistance and facilitating the exchange of information about promising practices of high quality, high impact, and effective preventive care delivery.
Preventive health care services include immunizations, screenings for common chronic and infectious diseases and cancers, clinical and behavioral interventions to manage chronic disease and reduce associated risks, and counseling to support healthy living and self-management of chronic disease. Prevention initiatives include the following:
- Medicaid Prevention Learning Network. The Medicaid Prevention Learning Network provides an opportunity for state Medicaid programs to engage in state-to-state learning and receive enhanced technical assistance to improve delivery of preventive health care in Medicaid and CHIP. In 2015, CMS began forming affinity groups to focus on prevention topics of common interest to states.
- School Based Health (SBH) Affinity Group Fact Sheet (PDF, 88.85 KB)
- Antipsychotic Drug Use in Children (ADC) Affinity Group Fact Sheet (PDF, 148.21 KB)
- Diabetes Prevention and Management Affinity Group Fact Sheet (PDF, 159.77 KB)
- HIV Health Improvement Affinity Group Fact Sheet (PDF, 145.42 KB)
- Tobacco Cessation Affinity Group Fact Sheet (PDF, 81.19 KB)
- Developmental and Behavioral Screening of Young Children (PDF, 143.66 KB) Periodic developmental and behavioral screening during early childhood can identify possible delays in growth and development, when steps to address deficits can be most effective. These screenings are required for children enrolled in Medicaid, and are also covered for children enrolled in CHIP.
- Early and Periodic Screening, Diagnostic and Treatment (EPSDT). Through the EPSDT benefit, Medicaid-eligible children under age 21 are assured coverage for preventive and comprehensive health services. The EPSDT benefit includes screening, vision services, dental services, hearing services, and other services necessary to correct or improve health conditions discovered through screenings.
- Immunizations. Medicaid plays a key role in the prevention of disease by facilitating access to vaccines and vaccine administration for children, adolescents and adults. CMS and the Centers for Disease Control and Prevention (CDC) jointly run the Vaccines for Children program, which provides vaccines to Medicaid and CHIP-enrolled youth.
- Maternal and Child Health. Prenatal, postpartum and neonatal care can affect the long-term health of both mother and child. In July 2014, CMS announced a new initiative to improve maternal and infant health outcomes. The Maternal and Infant Health Initiative is designed to improve the rate and content of postpartum visits in Medicaid and CHIP, and to increase access and use of effective methods of contraception among women in Medicaid and CHIP.
- Obesity. Over the last 20 years, the prevalence of obesity has increased in every U.S. state. Because many preventable chronic diseases and other health problems are associated with obesity, the obesity epidemic presents an urgent public health challenge. Medicaid and CHIP provide access to screenings and interventions to reduce obesity and promote healthy eating and physical activity.
- Oral Health. Oral health is an important part of overall health and prevention and early treatment of dental conditions can prevent future health problems. States are required to provide dental benefits to children covered by Medicaid and CHIP, but states choose whether to provide dental benefits for adults.
- Tobacco Cessation. Smoking causes disease and reduces the overall health of smokers. Tobacco use treatment is one of the most cost-effective clinical preventive services. Medicaid programs may cover a wide range of benefits, including counseling, quitlines, and pharmacotherapy to help beneficiaries quit smoking. States are required to cover tobacco cessation services for pregnant women.