The High Costs Associated with Missed Well-Child Visits

Published: July 10, 2024

The American Academy of Pediatrics recommends 13 well-child visits before the age of six because this schedule is associated with fewer hospitalizations and lower emergency department use. Unfortunately, on average, children miss 30% to 50% of these recommended checkups. A variety of social determinants may contribute to parents’/caregivers’ ability to get children to these crucial visits, including lack of transportation, inability to take time off from work, and inadequate childcare. Missing well-child visits contributes to higher rates of emergency department visits, hospitalizations, and delays in diagnosing developmental disorders.

 


 

Preventive care is key to babies’ and children’s health

Well-child visits provide opportunities for immunizations and screenings, and evaluate physical, emotional and social development. If early interventions are indicated for speech, fine motor, gross motor, or physical issues, the first three years of life are the time when these interventions are most effective. Consistent well-child visit attendance results in building trust with both parents and patients. In addition to identifying and treating disease, providers offer parenting guidance, help enforce healthy habits, and answer questions about child development and specific challenges.

Key facets of a pediatric well visit

As part of a well-child visit, providers:

  • Conduct age-appropriate screenings and assessments
  • Perform age-appropriate physical exam
  • Assess and document height, weight and BMI
  • Inform parent or caregiver of recommended immunization/vaccination needs
  • Use appropriate coding
  • Where applicable, convert sick visits to well-child visits

In addition to the identified schedule for screenings, healthcare providers support parents and caregivers in early identification of issues, and cover important topics such as sleep habits, safety, social and emotional health, nutrition, exercise, and behavior. Adherence to the well-child visit schedule not only results in better patient outcomes, it aligns with meeting contract quality goals. Many actions are also supported through ECIP, Equality Health’s activity-based payment program

The benefits of closing care gaps

Providers in the Equality Health network receive payment for completing well-child visits on a specified schedule. Our activity-based payment program pays providers quarterly for completing key panel management activities that maximize quality, improve patient outcomes and lower overall costs – such as preventive care well-child visits. Our proprietary software, CareEmpower®, can support providers in proactively scheduling patient visits through prioritized worklists. Providers also have access to the Care Coordination team who can assist with contacting and scheduling patients who may be more difficult to reach and connect with.