Maternal Infant Health Initiative
Infant Well-Child Visit Learning Collaborative
High-quality well-child visits can improve children’s health, support caregivers’ behaviors to promote their children’s health, and prevent injury and harm. The American Academy of Pediatrics and Bright Futures recommend nine well-care visits by the time children turn 15 months of age. These visits should include a family-centered health history, physical examination, immunizations, vision and hearing screening, developmental and behavioral assessment, an oral health risk assessment, a social assessment, maternal depression screening, parenting education on a wide range of topics, and care coordination as needed.i When children receive the recommended number of high-quality visits, they are more likely to be up-to-date on immunizations, have developmental concerns recognized early, and are less likely to visit the emergency department.ii,iii,iv,v,vi,vii In Federal Fiscal Year (FFY) 2019 Core Set reporting, the percentage of children receiving six or more well-child visits in the first 15 months of life was only 64 percentviii, and the COVID-19 pandemic has exacerbated the issue of foregone care.
The Maternal and Infant Health Initiative is launching the Infant Well-Child Visit Learning Collaborative to support state efforts to increase the number of infants receiving high-quality well-child care. The learning collaborative will offer technical assistance to state Medicaid and Children’s Health Insurance Program (CHIP) agencies and their partners using two modalities: a webinar series and an affinity group. The webinar series will include presentations from representatives for Medicaid and CHIP programs, as well as other experts in the field on strategies for states to improve the use of well-child visits for infants ages 0 to 12 months. Strategies covered in the webinars will include:
- Using data to identify disparities and increase participation in well-child visits;
- Engaging families, health care providers, and partner agencies;
- Using payment and incentives; and
- Leveraging evidence-based models of care.
States interested in putting these strategies into practice can participate in an action-oriented affinity group that will support the design and implementation of an infant well-child visit quality improvement project in their state.
All interested state Medicaid and CHIP programs, managed care plans, providers, state health departments, and other public health entities are encouraged to participate in the Infant Well-Child Visit Learning Collaborative webinar series beginning in August 2021.
Webinar #1: Using Payment, Policy and Partnerships to Improve Infant Well-Child Care
August 26, 2021
After providing a brief introduction to the purpose and structure of the Infant Well-Child Care Learning Collaborative, this webinar will focus on Medicaid and CHIP payment incentives, managed care contracts, and other strategies that can increase the use and quality of infant well-child visits and advance equity. Speakers from state Medicaid and CHIP agencies will describe their efforts to expand and incentivize participation in infant well-child visits, such as through value-based purchasing, performance improvement projects, CHIP Health Services Initiatives (HSIs), and partnerships with aligned service providers like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Presenters will discuss their successes, challenges, and lessons learned.
Webinar #2: Improving Quality and Utilization of Infant Well-Child Visits
September 10, 2021
This webinar will describe characteristics of a high-performing system of well-child care. Speakers from CMS and Mathematica will discuss the importance of infant well-child care, and state Medicaid and CHIP agencies will share how their states have achieved high rates of participation in infant well-child visits and how they use data to monitor performance and disparities, as well as ensure access to services.
Improving Quality and Utilization of Infant Well-Child Visits (Audio)(Transcript)(September 2021)
Webinar #3: Models of Care that Drive Improvement in Infant Well-Child Visits
September 22, 2021
This webinar will highlight state approaches to designing and implementing models of care associated with improved infant well-child visit participation, including patient-centered medical homes (PCMHs) and home visiting. To be effective at a state level, these approaches often require strategic alignment of policies, processes, and partnerships. Two state Medicaid and CHIP agencies and their partners will present on mobilizing PCMHs and home visiting to improve well-child care.
Models of Care that Drive Improvement in Infant Well-Child Visits (Audio)(Transcript)(September 2021)
Infant Well-Child Visit Affinity Group
States interested in improving infant well-child visit rates and quality are invited to join this action-oriented affinity group, which will help them design and implement a quality improvement project. Participating states will have access to quality improvement technical assistance support as they identify and implement strategies to improve well-child visits for infants ages 0 to 12 months. This opportunity is open to state Medicaid and CHIP agencies, which are encouraged to include representatives from managed care plans, providers, state health departments, and other relevant stakeholders as part of the state quality improvement team.
- Infant Well-Child Visit Affinity Group Fact Sheet
- Infant Well-Child Visit Affinity Group Expression of Interest Form
Information Session Webinar: Infant Well-Child Visit Affinity Group and Expression of Interest Process
September 27, 2021
This webinar will present the goals of the Infant Well-Child Visit Affinity Group for states, as well as the Expression of Interest form state teams need to submit to participate. Technical assistance staff will be available to answer questions about the Infant Well-Child Visit Affinity Group process.
Please contact the technical assistance mailbox at MACQualityImprovement@mathematica-mpr.com with any questions.
i 3 Hagan, J.F., J.S. Shaw, and P.M. Duncan (eds.). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2017.
ii Gill, J.M., A. Saldarriaga, A.G. Mainous, and D. Unger. “Does Continuity Between Prenatal and Well-Child Care Improve Childhood Immunizations?” Family Medicine, vol. 34, no. 4, April 2002, pp. 274–280.
iii Buchholz, M., and A. Talmi. “What We Talked About at the Pediatrician’s Office: Exploring Differences Between Healthy Steps and Traditional Pediatric Primary Care Visits.” Infant Mental Health Journal, vol. 33, no. 4, 2012, pp. 430–436.
iv DeVoe, J.E., M. Hoopes, C.A. Nelson, et al. “Electronic Health Record Tools to Assist with Children’s Insurance Coverage: A Mixed Methods Study.” BMC Health Services Research, vol.18, no. 1, May 2018, p. 354–360.
v Coker, T.R., S. Chacon, M.N. Elliott, et al. “A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial.” Pediatrics, vol. 137, no. 3, March 2016, p. e20153013.
vi Flores, G., H. Lin, C. Walker, M. Lee, J. Currie, R. Allgeyer, M. Fierro, M. Henry, A. Portillo, and K. Massey. “Parent Mentoring Program Increases Coverage Rates for Uninsured Latino Children.” Health Affairs, vol. 37, no. 3, 2018, pp. 403–412.
vii Hakim, R.B., and D.S. Ronsaville. “Effect of Compliance with Health Supervision Guidelines Among US Infants on Emergency Department Visits.” Archives of Pediatrics & Adolescent Medicine, vol. 156, no. 10, October 2002, pp. 1015–1020.