Strategy. Improve State/Systems-Level Policies and Practices
Approach. Partner with Medicaid and private payers to encourage adoption of annual well-visits standards and offer incentives
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Overview. Increasing partnerships with Medicaid to encourage the adoption of annual well-visits as an Early and Periodic Screening, Diagnostic and Treatment. (EPSDT) standard as well as offering incentives has been found to be effective. Partnering with Medicaid and private payers to receive reports on the percentage of patients who received well-visits has been effective in increasing access and utilization.
Evidence. Emerging Evidence.
Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").
Access the peer-reviewed evidence
through the MCH Digital Library or related evidence source.
(Read more about understanding evidence ratings).
Source. Peer-Reviewed Literature
Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):
- Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
- Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
- Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.
Intervention Type. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).
Intervention Level. Population/Systems-Focused
Examples from the Field.
Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).
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Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of meetings, workshops, and learning sessions convened by Title V agencies to educate Medicaid and private payers on the importance and benefits of annual adolescent well-visits. (Measures the efforts to build awareness and buy-in among payers)
- Number of Medicaid and private payer policies, guidelines, and incentive programs developed for modified to support the implementation of annual adolescent well-visit standards. (Measures the progress in establishing supportive payment and policy frameworks)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of Medicaid and private payer plans in the jurisdiction that have implemented annual adolescent well-visit standards and performance measures aligned with national guidelines (e.g., Bright Futures). (Measures the adoption and consistency of payer policies)
- Percent of Title V program staff and leaders who have received training and support to effectively engage and collaborate with Medicaid and private payers on adolescent well-visit initiatives. (Measures the capacity and competency of Title V agencies to partner with payers)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of joint quality improvement projects and initiatives undertaken by Title V agencies, Medicaid, and private payers to identify and address barriers to adolescent well-visit access and utilization. (Measures the level of collaborative effort to drive system-wide improvement)
- Number of policy briefs, reports, and presentations developed by Title V agencies to educate policymakers, legislators, and other community partners on the value and impact of payer partnerships for adolescent well-visits. (Measures the support and communication efforts to build broader support and investment)
- Number of healthcare systems and practices that implement evidence-based strategies and innovations to improve adolescent well-visit rates, with support and incentives from Medicaid and private payers. (Measures the impact of payer partnerships on driving health care delivery transformation)
- Number of state and local policies and budget allocations that prioritize and sustain funding for adolescent well-visit initiatives, leveraging Medicaid and private payer investments and partnerships. (Measures the long-term impact of payer partnerships on securing public health resources and commitment)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- Percent of Medicaid and private payer incentive programs that incorporate rewards for reducing gaps in adolescent well-visit rates and outcomes. (Measures the integration of accountability into payer incentive structures)
- Percent of Title V agency partnerships with Medicaid and private payers that engage and empower adolescents, families, and community community partners in the planning, implementation, and evaluation of well-visit initiatives. (Measures the level of patient and community partnership and input)
- Percent reduction in gaps for adolescent well-visit rates and preventive care outcomes between populations served by Medicaid and private payer plans participating in Title V partnerships and those served by non-participating plans. (Measures the impact of payer partnerships on advancing health and closing well-visit gaps)
- Percent of adolescents and families who report increased awareness, trust, and satisfaction with the well-visit services and support provided through Medicaid and private payer plans, as a result of Title V partnership efforts. (Measures the impact of payer partnerships on improving the patient experience and perception of care)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.
Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.
