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Using Medicaid Data to Improve Childhood Lead Poisoning Prevention Program Outcomes and Blood Lead Surveillance.
J Public Health Manag Pract. 2019 Jan/Feb; 25 Suppl 1, Lead Poisoning Prevention:S51-S57.JP

Abstract

CONTEXT

Wisconsin-specific data revealed that not all Medicaid providers were testing children appropriately for blood lead levels and not all blood lead tests were reported to the Department of Health Services, Childhood Lead Poisoning Prevention Program. The Medicaid program requires blood lead screening for all Medicaid-enrolled children at specific ages. Wisconsin state law requires reporting of all blood lead test results. Projects were implemented to encourage appropriate testing for Medicaid-enrolled children and improve blood lead surveillance.

METHODS

Medicaid billing data were linked to blood lead data to identify Medicaid-enrolled children who had not received the required tests. Medicaid provider report cards were distributed annually from 2006 to 2011 to inform providers of their compliance with federal testing requirements and of the names of children within their practice who had not been tested. Blood lead tests billed to Medicaid but not in the blood lead database were identified and billing providers were contacted to obtain the test report.

RESULTS

The number of children tested increased from 81 834 children per year in 2006 to 106 003 children per year in 2010. Testing of Medicaid-enrolled children increased by 31% from 2006 to 2010. The percentage of Medicaid-enrolled children receiving an age-appropriate test increased from 46% in 2004 to a high of 55% in 2010. There were 9035 blood lead tests identified in the Medicaid billing data that had not been reported from 2007 to 2015. There were 468 billing providers who had unreported tests. All sites with unreported tests were contacted, 84% of test results were obtained, and 14% of test records could not be retrieved. Outpatient clinics accounted for the majority of all unreported tests (72%) and irretrievable test records (74%).

DISCUSSION

Childhood lead poisoning prevention programs can effectively utilize Medicaid data to increase testing and improve blood lead surveillance. Primary health care providers should ensure that Medicaid-enrolled children in their care receive the age-appropriate tests. Many Wisconsin health care providers lack awareness of blood lead test reporting requirements. Outpatient clinics account for the largest proportion of unreported tests and highest priority should be given working with these sites to improve reporting practices.

Authors+Show Affiliations

Division of Public Health, Department of Health Services, Madison, Wisconsin (Ms Bruce, Dr Meiman, and Ms Walsh); and Departments of Ophthalmology and Visual Sciences (Dr Christensen), Population Health Sciences (Ms Coons), and Surgery (Mr Havlena), School of Medicine and Public Health, University of Wisconsin, Madison.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30507770

Citation

Bruce, Shelley A., et al. "Using Medicaid Data to Improve Childhood Lead Poisoning Prevention Program Outcomes and Blood Lead Surveillance." Journal of Public Health Management and Practice : JPHMP, vol. 25 Suppl 1, Lead Poisoning Prevention, 2019, pp. S51-S57.
Bruce SA, Christensen KY, Coons MJ, et al. Using Medicaid Data to Improve Childhood Lead Poisoning Prevention Program Outcomes and Blood Lead Surveillance. J Public Health Manag Pract. 2019;25 Suppl 1, Lead Poisoning Prevention:S51-S57.
Bruce, S. A., Christensen, K. Y., Coons, M. J., Havlena, J. A., Meiman, J. G., & Walsh, R. O. (2019). Using Medicaid Data to Improve Childhood Lead Poisoning Prevention Program Outcomes and Blood Lead Surveillance. Journal of Public Health Management and Practice : JPHMP, 25 Suppl 1, Lead Poisoning Prevention, S51-S57. https://doi.org/10.1097/PHH.0000000000000931
Bruce SA, et al. Using Medicaid Data to Improve Childhood Lead Poisoning Prevention Program Outcomes and Blood Lead Surveillance. J Public Health Manag Pract. 2019 Jan/Feb;25 Suppl 1, Lead Poisoning Prevention:S51-S57. PubMed PMID: 30507770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Using Medicaid Data to Improve Childhood Lead Poisoning Prevention Program Outcomes and Blood Lead Surveillance. AU - Bruce,Shelley A, AU - Christensen,Krista Y, AU - Coons,Marjorie J, AU - Havlena,Jeffrey A, AU - Meiman,Jon G, AU - Walsh,Reghan O, PY - 2018/12/4/entrez PY - 2018/12/7/pubmed PY - 2020/7/29/medline SP - S51 EP - S57 JF - Journal of public health management and practice : JPHMP JO - J Public Health Manag Pract VL - 25 Suppl 1, Lead Poisoning Prevention N2 - CONTEXT: Wisconsin-specific data revealed that not all Medicaid providers were testing children appropriately for blood lead levels and not all blood lead tests were reported to the Department of Health Services, Childhood Lead Poisoning Prevention Program. The Medicaid program requires blood lead screening for all Medicaid-enrolled children at specific ages. Wisconsin state law requires reporting of all blood lead test results. Projects were implemented to encourage appropriate testing for Medicaid-enrolled children and improve blood lead surveillance. METHODS: Medicaid billing data were linked to blood lead data to identify Medicaid-enrolled children who had not received the required tests. Medicaid provider report cards were distributed annually from 2006 to 2011 to inform providers of their compliance with federal testing requirements and of the names of children within their practice who had not been tested. Blood lead tests billed to Medicaid but not in the blood lead database were identified and billing providers were contacted to obtain the test report. RESULTS: The number of children tested increased from 81 834 children per year in 2006 to 106 003 children per year in 2010. Testing of Medicaid-enrolled children increased by 31% from 2006 to 2010. The percentage of Medicaid-enrolled children receiving an age-appropriate test increased from 46% in 2004 to a high of 55% in 2010. There were 9035 blood lead tests identified in the Medicaid billing data that had not been reported from 2007 to 2015. There were 468 billing providers who had unreported tests. All sites with unreported tests were contacted, 84% of test results were obtained, and 14% of test records could not be retrieved. Outpatient clinics accounted for the majority of all unreported tests (72%) and irretrievable test records (74%). DISCUSSION: Childhood lead poisoning prevention programs can effectively utilize Medicaid data to increase testing and improve blood lead surveillance. Primary health care providers should ensure that Medicaid-enrolled children in their care receive the age-appropriate tests. Many Wisconsin health care providers lack awareness of blood lead test reporting requirements. Outpatient clinics account for the largest proportion of unreported tests and highest priority should be given working with these sites to improve reporting practices. SN - 1550-5022 UR - https://www.unboundmedicine.com/medline/citation/30507770/Using_Medicaid_Data_to_Improve_Childhood_Lead_Poisoning_Prevention_Program_Outcomes_and_Blood_Lead_Surveillance_ L2 - https://doi.org/10.1097/PHH.0000000000000931 DB - PRIME DP - Unbound Medicine ER -