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Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life

The American Academy of Pediatrics and Bright Futures recommend children have at least one  well-child visit to 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 one or more well-child visits with a PCP. Higher rates are better.

The purple dashed line represents the median, or middle of all values reported.

This measure reports 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
  • Immunizations
  • 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 reporting methods for Child Core Set measures can vary by state. For example, some states report data on certain populations such as those covered under managed care but not those covered under fee-for-service (FFS). This variation in data and calculation methods can affect measure performance and comparisons between states.

Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports as of June 3, 2019 for the Child Core Set Federal Fiscal Year (FFY) 2018 reporting cycle; see 2018 Child and Adult Health Care Quality Measures. For more information on Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34-CH) visit Child Health Care Quality Measures.

Notes:

The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: CO, ID, and ND.

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) 2018 specifications. The following states used NCQA 2017 specifications: NV and 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, 2017 to December 31, 2017. AZ reported data for FFY 2016.

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; 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.