Paying for Improvements

Early Childhood Services Costs, Financing, and Return on Investment

ABCD states each endeavored (and still continue to do so) to improve the delivery of care to young children, mostly without seeking new appropriations, changing state law, or obtaining federal approval. States found that they could make improvements to care without new funding or legislation They accomplished their work by leveraging existing resources (such as federal EPSDT provisions) and partnering with other stakeholders, including their sister agencies, private organizations, and providers.

This section includes resources on the costs and financing associated with the delivery of early childhood health and developmental services. It includes a guide to federal funding for early childhood supports and services, an evidence base for the types of programs that have been demonstrated to be effective, the potential for returns to society that exceed the resources invested in program delivery, and specific information on ABCD states’ strategies to pay for improvement.

Title Description Date Published Resource State
Billing Codes for Iowa’s EPSDT Care for Kids Services  Iowa Department of Human Services. This section of the EPSDT Care for Kids website contains billing code information for developmental, social, emotional, and family risk screening as well as developmental and mental health assessment and diagnosis.  It clarifies that providers may crosswalk the Early Childhood DC: 0-3 with the DSMIV or ICD-9 diagnostic codes to bill for the screening service. January 2009  State-specific  Iowa
Improving Early Childhood Health and Developmental Services Using EPSDT Policy: EPSDT Services and the Coding Conundrum Joel Bradley, (Americhoice by United Health Care, 2009). This PowerPoint presentation describes the correct coding for EPSDT services and helps readers understand how the correct use of existing coding systems can facilitate EPSDT data tracking and provide opportunities to reward providers for higher screening rates. Dr. Bradely presented this information to EPSDT Coordinators during a webcast of the same name in March 2009. January 2009  NASHP-Commonwealth
Medicaid Reimbursement Numbers Medicaid reimbursement codes by carrier and state. accessed and compiled by Dr. Michelle Macias, September 2007. September 2007 Other
ABCD local funding resource document Jennifer May. (Portland, ME: National Academy for State Health Policy, 2006.) This resource explores what ABCD Consortium states accomplished by partnering with local funders to support children’s healthy development. December 2006 NASHP-Commonwealth
Billing and Policy Technical Assistance North Carolina ABCD Project. (2006). This PowerPoint presentation clarifies billing procedures for developmental screening around existing EPSDT requirements for Medicaid eligible children as well as providing state-specific information on billing private insurers. December 2006 State-specific North Carolina
Investing in Infants and Toddlers: The Economics of Early Childhood Kimberly Lucas. (Washington, DC: Zero to Three Policy Center, September 2006). This article outlines current economic research, its application within the field of child development, and ways in which early childhood professionals and economists can join forces to advocate for greater investment in program s that support infants, toddlers, and their families. (From Overview) September 2006 Other
Financing Strategies for Medicaid Reimbursement of Maternal Depression Screening by Pediatric Providers Karen VanLandegehm. (Portland, ME: National Academy for State Health Policy, April 2006). This news brief explores how pediatric providers (e.g., pediatricians, family physicians, and nurse practitioners) can play a key role in early intervention for maternal depression and provides sound financing strategies for Medicaid reimbursement. April 2006 NASHP-Commonwealth
Early Childhood Interventions: Proven Results, Future Promise Lynn Karoly, M. Rebecca Kilburn, Jill Cannon. (San Diego, CA: The Rand Corporation, January 2006). This report explores the potential consequences of not investing additional resources in the lives of children as well as the range of early intervention programs, the demonstrated benefits of interventions with high-quality evaluations, the features associated with successful programs, and the returns to society associated with investing early in the lives of disadvantaged children. (From web overview) January 2006 Peer-reviewed
Views on the Early Childhood Mental Health System in Ramsey County Cheryl Holm-Hansen. (Foundations For Success newsletter, December 2005). This report summarizes the results of a survey of mental health services in Ramsey County. December 2005 State-specific  Minnesota
Illinois ABCD II Healthy Beginnings Pilot Community Evaluation Report: Baseline data Illinois ABCD Healthy Beginnings. (July 2005). This report outlines baseline data (collected in needs assessments and surveys described elsewhere) prior to project implementation and outlines the initiative’s goals to build the social/emotional health capacities of pediatricians and family physicians. July 2005 State-specific  Illinois
State Medicaid Policy for Reimbursement of Maternal Depression Screening Illinois ABCD Healthy Beginnings. (March 4, 2005). This resource outlines the Illinois State Medicaid Policy for Reimbursement of Maternal Depression Screening. March 2005 State-specific  Illinois
How Medical Claims Simplification Can Impede Delivery of Child Developmental Services Anne Markus, Sara Rosenbaum, and Alexandra Stewart. (New York, NY: The Commonwealth Fund, August 2005). This report examines HIPAA administrative standardization and the process of modifying the standardized codes. It assesses the implications of HIPAA standardization for payment of Medicaid-covered early childhood preventive and developmental services, drawing on findings from a 50-state, point-in-time review of readily available state HIPAA compliance documents conducted in December 2004. (From web Executive Summary) December 2004 NASHP-Commonwealth
Illinois provider notice: Billing for Screenings Under the Healthy Kids Program Illinois Department of Public Aid (2004) Provider notice explaining Illinois attempt to unbundle payment for Developmental screening services to ensure policies conform with Medicaid reimbursement rules. December 2004 State-specific  Illinois
Illinois provider notice: Screening for Perinatal Depression Illinois Department of Public Aid (2004) This notice provides information on DPA’s initiation of reimbursement for screening for perinatal depression and information about consultation services available to providers. December 2004 State-specific  Illinois
Strategic Financing: Making the Most of the State Early Childhood Comprehensive Systems-Building Initiative Cheryl Hayes, Margaret Flynn, Helene Stebbins. In: Halfon N, Rice T, Inkelas M, eds. Building State Early Childhood Comprehensive Systems Series, No. 5. (Los Angeles, CA: National Center for Infant and Early Childhood Health Policy, 2004). December 2004 Other
Coding and Reimbursement for Developmental Screening North Carolina ABCD I Project.(2003). Description of coding and reimbursement procedures for preventive visits for various public and private payors. December 2003 State-specific  North Carolina
Early Childhood Development: Economic Development with a High Public Return, web-based fedgazzette March 2003 Art Rolnick and Rob Grunewald. fedgazette, (Minneapolis, MN: Federal Reserve Bank of Minneapolis, March 2003). This study finds that well-focused investments in early childhood development yield high public as well as private returns and how this return on investments in early childhood development results in better working public schools, more educated workers, and less crime. (From Introduction) March 2003 Other
Making Dollars Follow Sense: Financing Early Childhood Mental Health Services to Promote Healthy Social and Emotional Development in Young Children Kay Johnson, Jane Knitzer, Roxane Kauffman. (New York, NY: National Center for Children In Poverty, 2002). This report highlights innovative approaches states and communities have used to finance preventive and early intervention services, as well as more traditional mental health treatment services for young children. It explores what else might be done to mix, match, and leverage all available resources for early childhood mental health needs. (From web Overview) December 2002 Other
Using Title V Maternal & Child Health Services Block Grant to Support Child Development Services NASHP (Portland, ME: National Academy for State Health Policy, March 2002)  News from the Assuring Better Child Health and Development Program: The flexibility of Title V allows for it to be an originating and supportive source for child development programs, including direct care for mothers and children as well as interventions for an entire family. This brief examines state flexibility to maximize Title V funding and Title V Coordination requirements. March 2002 NASHP-Commonwealth
Using Title V Maternal & Child Health Services Block Grant to Support Child Development Services Sara Rosenbaum, Michelle Proser, Andy Schneider, et al., (New York, NY: The Commonwealth Fund January 2002). This report explains how services provided through the Title V Maternal and Child Health Services Block Grant can be used to foster optimal child development intervention services in the early years of life. (From Executive Summary) January 2002 NASHP-Commonwealth
Assessing Costs and Benefits of Early Childhood Intervention Programs: Overview and Application to the Starting Early Starting Smart Program Lynn A. Karoly, M. Rebecca Kilburn, James H. Bigelow, et al. (Santa Monica, CA: RAND, 2001). This report identifies the conceptual and methodological issues associated with the analysis of costs and outcomes of early intervention programs in general and makes recommendations regarding the application of these tools for subsequent demonstration studies of a particular intervention program: Starting Early Starting Smart. (From Introduction) December 2001 Peer-reviewed
Estimating the cost of developmental and behavioral screening of preschool children in general pediatric practice Deborah Dobrez, et al. Pediatrics. Oct 2001: 108(4): 913-922. This article develops a model for estimating the cost of providing pediatric developmental and behavioral screening that can be scaled to reflect a pediatric practice’s patient population and choice of screening offered. (From abstract) October 2001 Peer-reviewed

Leave a Reply