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Maximizing the Use of EPSDT to Improve the Health and Development of Young Children
Short Take No. 2

Author: Kay Johnson
Publication Date: June 2006

This is an excerpt from the full brief.

The Issue

In every state, assuring access to health care and a medical home is a core component of the Early Childhood Comprehensive System (ECCS) initiative.Medicaid finances health, mental health, and developmental services for approximately one-third of U.S. children under age 6. This Project THRIVE Short Take discusses the importance of Medicaid’s child health benefit—the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. EPSDT is in essence the child health benefit plan for Medicaid. Short Take 2 reviews research about the role of EPSDT in improving early childhood health and development and opportunities for ECCS leaders to use EPSDT in collaborative efforts to improve child health.

What Research Says About Medicaid, EPSDT, and Young Children

  • An estimated 35-40 percent of births are financed by Medicaid, with coverage continuing throughout the first year of life for infants. In some states, approximately half of all births are covered. Virtually all of the infants whose births were financed by Medicaid will have automatic and continuous coverage until age 1 year.
  • Approximately one-third of children ages 1 to 5 years are covered by Medicaid.  This means that many early childhood health and developmental services in each state will be financed by Medicaid.
  • With Medicaid, poor children’s access to health care is similar to that of nonpoor, privately insured children. Moreover, child Medicaid beneficiaries use care in approximately the same pattern as their privately insured counterparts.
  • Children are half of all Medicaid enrollees, but represent less than 20 percent of the total spending—primarily because they use less expensive primary and preventive services.