Screening Ratio Analysis
During the current Federal Fiscal Year (FFY) reporting period (10/1/2014 – 6/30/2015), WellCare had 64,241 unduplicated PeachCare for Kids (PCK) eligible members due for initial or periodic screenings under the age of 21 and of those eligible members, 44,339 total screenings were received. There were 104,064 unduplicated PCK Medicaid members enrolled with WellCare who were eligible for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. Of these eligible PCK Medicaid members, 79,664 were enrolled with WellCare for at least 90 continuous days. WellCare overall PCK screening ratio is 69% which increased this reporting period by 7 percentage points from the previous reporting period of 62%. The Healthy Behaviors …show more content…
According to the CMS-416 data, WellCare performed a total of 2,802 blood lead screenings, an increase of 42% from the previous reporting period. The 12-24 month age group completed 1,850 blood lead screenings which resulted in a 32% increase from the previous reporting period. According to claims data, PCK Medicaid members identified without a Blood Lead Screening between 12 and 24 months of age were the highest among Caucasians and an unknown racial origin in the Atlanta region. See Figure 4. This may be due to several factors such as no identified lead risk factors, member may have already received a blood lead screening with a previous carrier and/or may have had other primary insurance not reported to the secondary carrier. Members are continuously outreached and educated regarding required EPSDT services through Periodicity Letters, Centralized Telephonic Outreach, Case Management Lead Program and the Customer Service Inbound Program, see Targeted Strategies and
During the current Federal Fiscal Year (FFY) reporting period (10/1/2014 – 6/30/2015), WellCare had 64,241 unduplicated PeachCare for Kids (PCK) eligible members due for initial or periodic screenings under the age of 21 and of those eligible members, 44,339 total screenings were received. There were 104,064 unduplicated PCK Medicaid members enrolled with WellCare who were eligible for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. Of these eligible PCK Medicaid members, 79,664 were enrolled with WellCare for at least 90 continuous days. WellCare overall PCK screening ratio is 69% which increased this reporting period by 7 percentage points from the previous reporting period of 62%. The Healthy Behaviors …show more content…
According to the CMS-416 data, WellCare performed a total of 2,802 blood lead screenings, an increase of 42% from the previous reporting period. The 12-24 month age group completed 1,850 blood lead screenings which resulted in a 32% increase from the previous reporting period. According to claims data, PCK Medicaid members identified without a Blood Lead Screening between 12 and 24 months of age were the highest among Caucasians and an unknown racial origin in the Atlanta region. See Figure 4. This may be due to several factors such as no identified lead risk factors, member may have already received a blood lead screening with a previous carrier and/or may have had other primary insurance not reported to the secondary carrier. Members are continuously outreached and educated regarding required EPSDT services through Periodicity Letters, Centralized Telephonic Outreach, Case Management Lead Program and the Customer Service Inbound Program, see Targeted Strategies and