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Changes in Medicaid Coverage Impact Health Department's Services for Children with Medicaid

Monday, May 20, 2013

Even healthy children should be regular visitors to their pediatrician or family doctor. A total of 25 well-child exams are recommended at various intervals between birth and age 20. This regular health care allows children to have comprehensive care and screening for physical, emotional and social problems; as well as get the recommended immunizations and school physicals.

 In the past, the Northern Kentucky Health Department has provided well-child health care to those children covered by Medicaid. But, a shift in reimbursement guidelines mean that children are now required to get well care at their regular doctors.

It’s estimated that 1,800 families throughout Boone, Campbell, Grant and Kenton counties will be affected by these changes.

“Children are better served by one person who can keep track of their on-going health and well-being—both when they are sick and well,” said Lynne M. Saddler, MD, MPH, District Director of Health. “By requiring children with Medicaid to see their regular doctor for this care, families will get better overall care management, and build relationships with providers in that practice.”

The Health Department’s four county health centers will still serve as a safety-net provider for children who do not have private health insurance or do not qualify for Medicaid. Well-child care will be offered for those children. Additionally, if children are assigned to a doctor’s office who does not provide free vaccinations through the federal Vaccines for Children program, the Health Department can see those children for immunizations only. For a list of health center locations, please visit http://www.nkyhealth.org/locations.

Children with private health insurance coverage have traditionally gone to and will continue to go to their pediatrician or family doctor for well care and immunizations.

“Fortunately, most families already have a primary care provider assigned to them,” said Saddler. “For those children with Medicaid, a provider is assigned at sign-up. If a family is not connected with someone, they can contact the Department for Community-Based Services, their Medicaid Managed Care Organization or their health insurance company for a referral.”

Making regular visits to a doctor when children are healthy assures that all children receive the treatment they need to improve/maintain their health. Routine check-ups, blood lead screenings, hearing testing, vision testing, immunizations and nutrition education are all part of these visits. Should a child have any problems, a regular doctor can manage his/her care and refer to specialists as needed.  

The American Academy of Pediatrics also notes that well-child visits give parents a chance to raise questions and concerns about their child’s development, behavior, and general well-being — questions that are difficult to discuss during sick visits.

The Health Department has reached out to local schools, physicians’ offices and child care providers to help inform families of the changes to well-child care. For more information about the changes in well-child care at the Health Department, please visit http://www.nkyhealth.org/wellchild.

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Media representatives should contact Emily Gresham Wherle at 859.344.5470 or Emily.Gresham-Wherle@nkyhealth.org, about any request or information before calling any other Health Department employee. Your calls and requests will be handled expediently with your deadlines in mind. Thank you for your interest and support in educating the community about public health issues.

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