EPSDT & Title V Collaboration to Improve Child Health
The Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Program is the child health component of Medicaid. It's required in every state and is designed to improve the health of low-income children, by financing appropriate and necessary pediatric services. This website provides information about how EPSDT works with public health, families, managed care organizations, pediatricians, and other health providers.
State Title V Agencies
Roles in EPSDT Programs
State Title V agencies can play an important role in fulfilling the potential of EPSDT. Federal rules encourage partnerships between State Medicaid and Title V agencies to assure better access to and receipt of the full range of screening, diagnostic, and treatment services. States’ experiences show how collaboration can improve access and administrative efficiency.
More on EPSDT and Title V
George Washington University Health Policy
Managed Care Purchasing Specifications
Using Managed Care Contracts to Promote Child Health (PDF - 72 pages)
Supporting a Child Health
System Using EPSDT
Local health care systems vary greatly, based on provider supply, public health structures, health coverage patterns, and State laws. Increasing the efficacy of linkages between pediatric providers and other child serving entities is one key step toward improving care and services for families.
More on System of Care Issues
EPSDT is designed to address physical, mental, and developmental health needs. Screening services “to detect physical and mental conditions” must be covered at periodic intervals and when, as well as diagnostic and treatment coverage.
More on EPSDT Benefits
Millions are enrolled with managed
care organizations (MCOs) operating under contracts with Medicaid. The George Washington University’s (GWU) Managed Care Purchasing Specifications offer sample language that can be used by states, MCOs, and family advocates to enhance Medicaid managed care contract language and improve child health services.
More on Managed Care and EPSDT
For over 35 years, EPSDT has evolved. As Medicaid changed (e.g, use of managed care), States clarified EPSDT rules. Congressional and court actions have also had an effect on the program. It adapted to changing pediatric guidelines. The program’s purpose is “to discover, as early as possible,” and provide “continuing follow up and treatment so that handicaps do not go neglected.”
More about EPSDT Policy