Our Bright Futures work aims to improve the health of our nation’s infants, children, youth, and young adults. It does this by developing and sharing clinical guidelines that:
- Are age-specific
- Are based on the best available scientific evidence
- Help increase the quality of primary and preventive care
We launched Bright Futures in 1990 to address a need for unified guidance on how to design the most modern, efficient, and comprehensive pediatric checkup. Now, our fiscal year 2023 Infant, Child, and Adolescent Preventive Services (ICAPS) funding makes sure that the Bright Future guidelines continue to stay up to date.
The American Academy of Pediatrics (AAP) is HRSA’s current Bright Futures awardee. AAP’s website offers resources for state-level public health agencies, clinicians, and families.
Some of the Bright Future program activities include:
- Reviewing new scientific evidence on an ongoing basis and annually publishing relevant updates to Bright Futures periodicity schedule and related resources.
- Ensuring that accredited pediatric residency programs integrate Bright Futures Guidelines within training.
- Training practicing primary care clinicians on the use of Bright Futures Guidelines and resources within clinical preventive services.
- Providing annual training to each of the 59 state maternal and child health (MCH) programs on the use of Bright Futures resources.
- Providing families with Bright Futures resources to help them prepare for preventive checkup visits with their primary care clinician.
What is the Bright Futures Periodicity Schedule?
One part of the Bright Futures Guidelines is the Periodicity Schedule. The Bright Futures Periodicity Schedule recommends services that pediatric providers should offer at every well-child visit from before birth to age 21.
All children receive certain assessments, screenings, and procedures at each visit. For example, at each visit the pediatric provider will:
- Ask about emotional and physical development
- Perform a physical examination and track physical growth and development
- Provide recommended immunizations
- Share guidance to help children and adolescents stay healthy
Providers will conduct other assessments, screenings and procedures based on age or specific risks. For example, providers may:
- Verify the results of newborn screenings
- Check blood lead levels in early childhood
- Screen for elevated lipid levels in middle childhood
- Assess an adolescent's risk for a sexually transmitted disease or HIV
All non-grandfathered group health plans and health insurance issuers offering group or individual health insurance coverage must cover the services and screenings listed on the current Bright Futures Periodicity Schedule.
Does insurance cover the services Bright Futures recommends?
Under the Affordable Care Act (ACA), certain group health plans and insurance issuers must provide coverage with no out-of-pocket cost for the comprehensive preventive care and screening services provided for HRSA-supported guidelines. This includes Bright Futures recommendations.
What are the latest updates to the Periodicity Schedule?
On December 30, 2022, HRSA accepted an update to the current version of the Bright Futures Periodicity Schedule for purposes of Section 2713 of the Public Health Service Act (42 U.S.C. § 300gg-13) and 45 CFR Part 147). For more details, please refer to the Federal Register Notice.
The current Bright Futures Periodicity Schedule (PDF - 344 KB) is available through the American Academy of Pediatrics. To receive updates on Bright Futures along with health promotion and prevention content, subscribe to Bright Futures eNews.
The updates to the Periodicity Schedule are:
- HIV screening update:
- Recommended range for universal HIV screening is between the 15-year visit and 21-year visit.
Bright Futures in the broader context
Bright Futures Guidelines are sometimes used by groups other than pediatric primary care clinics. For example, Bright Futures is used by:
- Special clinics offering primary care in schools supported by the School Based Health Alliance
- Rural or underserved areas supported by Healthy Tomorrows Partnership for Children Program
- Public health institutions looking for ways to measure population health like states who receive the Title V Block grant and measure progress by using National Performance Measure 6: Developmental Screening and 10: Adolescent Well Visit
- The American Academy of Pediatrics website healthychildren.org to let families and caregivers know what to expect from their visit to the doctor.
The Centers for Disease Control and Prevention provides the Recommended Child and Adolescent Immunization Schedule for ages 18 or younger (2021)