title: Improving the rate and quality of medicaid well child care exams in primary care practices.
abstract: BACKGROUND
  Providing recommended well child care to children insured bythe Medicaid Program can be challenging. Members of the Department of Family and Preventive Medicine (DFPM) at the University of Oklahoma Health Sciences Center contracted to help practices improve the rates and quality of well child care visits within the Oklahoma Medicaid Program.
  
  
  METHODS
  Sixteen pediatric and family medicine practices in three Oklahoma counties chose to participate in this quality improvement initiative. The records of Sooner Care-insured children age 0-20 were reviewed for both rate and quality of well child care visits made during the previous twelve months. Performance feedback was provided. Practice guidelines, Sooner Care requirements, and tips from exemplary practices were provided. In two of the counties, a case manager helped practices with challenging patients. Practice Enhancement Assistants (PEAs) then helped practices implement a variety of strategies to increase visit rates and improve the quality of early and periodic screening, diagnosis, and treatment (EPSDT) visits. Information technology (IT) support was provided when needed.
  
  
  RESULTS
  The average rates of visits, for all counties combined, increased. Visit rates increased more in the younger age groups (birth to two years). There was significant improvement in quality of visits. Rates and quality improved much more in some practices than in others.
  
  
  CONCLUSIONS
  A combination of academic detailing, performance feedback, practice facilitation, case management, and IT support produced increases in the quality and rates of EPSDT exams.
authors.affiliation: katy-smith@ouhsc.edu
authors.forename: Katy Duncan
authors.initials: KD
authors.lastname: Smith
authors.forename: Eileen
authors.initials: E
authors.lastname: Merchen
authors.forename: Crystal D
authors.initials: CD
authors.lastname: Turner
authors.forename: Cara
authors.initials: C
authors.lastname: Vaught
authors.forename: Terrie
authors.initials: T
authors.lastname: Fritz
authors.forename: Jim
authors.initials: J
authors.lastname: Mold
mesh_terms: D000293:Adolescent; D019090:Case Management / Q000592:standards; D002648:Child; D002675:Child, Preschool; D005194:Family Practice; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008484:Medicaid / Q000592:standards*; D009825:Oklahoma; D011322:Primary Prevention / Q000592:standards*; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D014481:United States; D055815:Young Adult