Follow-up of childhood lead exposure falls short

Only 18 states require that children on Medicaid who have elevated blood lead levels receive in-home follow-up services mandated by Medicaid’s Early Periodic Screening, Diagnostic, and Treatment benefit, according to a recent report.

The report of a survey by the National Center for Healthy Housing and Milken Institute School of Public Health at George Washington University documents Medicaid reimbursement practices for home-based environmental health services for children exposed to lead and children and adults with asthma. It also discusses opportunities to increase access to services.

Although 27 states provide Medicaid reimbursement for either lead or asthma services, most states don’t mandate the benefits, the survey found. Ensuring that Medicaid patients who need the services get them could reduce the considerable costs associated with housing-related lead poisoning and asthma in children.

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The authors of the report plan more research into how states translate policy into services and how to help state and local agencies further explore healthcare financing for home-based services. In some states, the report notes, private payers, hospitals, and other providers are considering ways to move beyond Medicaid reimbursement by using such means as accountable care organizations, hospital community benefits, and social impact bonds to link home-based services with clinical care. 

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