The American Academy of Pediatrics and Bright Futures recommend children have at least one well-child visit with a primary care practitioner (PCP) each year. Early intervention increases overall wellness and reduces medical costs.
Explore the percentage of children ages 3 to 6 who had at least one well-child visit with a PCP in each state. Higher rates are better on this measure.
The purple dashed line represents the median, or middle, of all values reported.
This measure reports state performance on the percentage of children ages 3 to 6 who had one or more well-child visits with a PCP during the measurement year.
Well-child visits should include:
- A health history
- Physical examination
- Vision and hearing screening
- Developmental/behavioral assessment
- An oral health assessment (at ages 3 and 6)
- Parenting education on a wide range of topics
States voluntarily report on Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34-CH) as part of the Core Set of Children's Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Child Core Set measure specifications.
The included populations and calculation methods for Child Core Set measures can vary by state. For example, some states report a single combined rate for both the Medicaid and CHIP populations, but other states report separate rates for these populations. In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. For example, a state may include beneficiaries who are enrolled in managed care, but exclude beneficiaries who are covered on a fee-for-service (FFS) basis. States can also choose to calculate this measure using the administrative or hybrid method. This variation in populations and calculation methods can affect measure performance and comparisons between states.
Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Child Core Set Federal Fiscal Year (FFY) 2020 reporting cycle as of June 18, 2021; see 2020 Child and Adult Health Care Quality Measures. For more information on the Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34-CH) measure, visit Child Health Care Quality Measures.
The term “states” includes the 50 states, the District of Columbia, and Puerto Rico. The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: ID and MT.
The Child Core Set specifications include guidance for calculating this measure using the administrative method or the hybrid method. The hybrid method uses a combination of administrative and medical records data to identify services included in the numerator or to determine exclusions from the denominator based on diagnoses or other criteria. Unless otherwise specified, administrative data sources are the state’s Medicaid Management Information System (MMIS) and/or data submitted by managed care plans; medical record data sources are paper and/or electronic health records.
Unless otherwise specified:
- States used Child Core Set specifications, based on National Committee for Quality Assurance (NCQA) 2020 specifications. The following state used NCQA 2019 specifications: OR.
- Denominators are assumed to be the measure-eligible population for states using the administrative method; states using the hybrid method often reported the sample size for the medical chart review rather than the measure-eligible population. Some states reported exclusions from the denominator, as noted in the state-specific comments.
- The measurement period for this measure was January 1, 2019 to December 31, 2019. KY reported data for CY 2018 and AZ reported data for FFY 2019.
ACO = Accountable Care Organization; ADHD = Attention-Deficit/Hyperactivity Disorder; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CPT = Current Procedural Terminology; CY = Calendar Year; ED = Emergency Department; EPSDT = Early and Periodic Screening, Diagnostic, and Treatment; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.