Access to standardized developmental screening is an important measure of the quality of pediatric primary care.
For that reason, the CHIPRA Core Set of Children’s Health Care Quality Measures includes an indicator of access to developmental screening (DEV-CH) for children enrolled in Medicaid and CHIP. This measure, developed at Oregon Health and Science University, is used to monitor the receipt of developmental screening during each of the first three years of a child’s life.
Twenty-five states voluntarily reported the measure to the Centers for Medicare & Medicaid Services (CMS) in 2018. See the map below for more information. State data is available from CMS.
The National Survey of Children’s Health includes an indicator of access to developmental screening for children aged 10 months to 5 years, based on parental reports. HRSA’s Title V Maternal and Child Health Block Grant program includes a national performance measure (NPM 6) that monitors developmental screening using this indicator. Forty state Title V programs have prioritized this performance measure. States agencies may use the above or other measures internally to monitor access to developmental screening. Measures may be used in Medicaid performance improvement projects or other quality monitoring efforts. See the Medicaid Incentives and Improvement Projects map below to learn more. Because these measures rely on different data sources (e.g., Medicaid claims, medical chart reviews, parent telephone surveys) and specifications, developmental screening measurement is not aligned across systems or programs.
Policy Trends
State Reporting of CHIPRA Development Screening Core Measure
- There was a 15-fold increase in the number of states reporting the CHIPRA core measure for developmental screening between 2010 to 2020 (from 2 to 31 states).
- The number of states reporting the measure increased most between 2012 (12) to 2013 (20).
- As of 2020 (the most current data, released in 2021), 36 states have historically reported the measure at least once while 15 states have never reported the measure.
- Four states (Idaho, Kansas, Nevada and North Dakota) reported the measure for the first known time in 2020.
Sources: 2011, 2012, 2013, 2014, 2015 Annual Reports on the Quality of Care for Children in Medicaid and CHIP; 2016, 2017, 2018, 2019, 2020 Annual Reporting on the Quality of Care for Children in Medicaid and CHIP Chart Packs
Medicaid Incentives and Measures for Developmental Screening
- 8 states have an incentive for developmental screening.
- 14 states have a performance measure for developmental screening.
- 3 states (Connecticut, Massachusetts, Oregon) have or are in the process of implementing an incentive metric for developmental screening as part of broad Medicaid payment or delivery reform, such as a State Innovation Model grant-funded initiative.
This information is based on 2019 NASHP research funded by the Health Resources and Services Administration.
