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From Screening to Better Outcomes


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Dr. Jin Lee and Patricia Herrera, M.S.will discuss challenges for providers in performing developmental screenings and how innovative new technology can help overcome some of the current barriers.The webinar will include information for providers on how to streamline the developmental screening process, receive reimbursement for performing screenings, and educate and connect parents to timely and effective intervention services.

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From Screening to Better Outcomes

  1. 1. 1 FROM SCREENING TO BETTER OUTCOMES An End-to-End Child Health Platform
  2. 2. Speakers Dr. Jin Lee Founder & CEO 2 Patricia Herrera, M.S. Program Director
  3. 3. 3 Audience Participation Please use the chat function to ask questions throughout the presentation. We will try to get to as many as we can at the end!
  4. 4. Agenda 4 1. Screening Statistics and Barriers 2. BabyNoggin and 211LA’s Partnership 3. Educating and Engaging Parents 4. Creating Workflow Efficiency 5. Accessing Reimbursement 6. Benefits of Care Coordination
  5. 5. Source: 2015 First 5. 2018 Children now 1 out of 4 Children Is at Risk for Delays 5
  6. 6. 6 - 21% of kids are screened - California has received a C- since 2014 Too Little Screening
  7. 7. Source: From the Doctor’s Office: California Pediatrician Survey on Early Childhood Developmental Screening. June 2017. Why don’t PCP’s screen? 86% Lack of time 73% Cost 64% No services to refer to 62% Unfamiliarity with tools 55% Lack of training 7
  8. 8. 8 Follow-Up and Tracking Challenges Even with increased rates of developmental screening, research has demonstrated: ● Families often struggle with follow-up (Jimenez, et al. 2012) ● Few clinics have systems for tracking outcomes (King, et al. 2010)
  9. 9. Audience Polling Question: In your experience, which of the following are significant barriers to the effective use of validated developmental screening tools (e.g., PEDS, ASQ-3)? a. lack of time b. cost c. lack of services to refer to d. unfamiliarity with tools e. lack of training 9
  10. 10. 10 BabyNoggin and 211LA
  11. 11. 11 Automated Scoring
  12. 12. ©BabyNoggin- PROPRIETARY & CONFIDENTIAL 12 Parent Education through Self-Screening
  13. 13. 13 Less Paperwork = More Time for Patients
  14. 14. CPT codes: 96110 & 96127 Reimbursement (per child per screening per visit) 3 screenings/ year for up to age 3: 500 children Non-Managed Medicaid1 $59.9 $89,850 Private insurance $10-$40 $15,000 - $60,000 14 Screenings Are Reimbursable Source: Mention N & Heider, F. The nuts and bolts of medicaid reimbursement for developmental screening: sights from Georgia, Minnesota, and North Carolina. 2016. National Academy for State Health Policy. 2) CMS. Quality initiatives patient assessment instruments/ quality measures. 2017.
  15. 15. 78% Increased understanding of developmental milestones 80% Complete 1+ screening 5/5 App review 15
  16. 16. Empower Parents ● Video instructions ● Suggestions for developmental activities ROI ● Saves time ● Earn more in reimbursement Provide Better Care ● Adherent to AAP guidelines ● Eliminate scoring errors Benefits 16
  17. 17. Audience Polling Question: How often do you use a validated developmental screening tools, such as the PEDS or ASQ-3? a. every visit b. only at AAP-recommended visits: 9, 18, 24/30 months c. only when there are concerns 17
  18. 18. 18 211 LA Early Childhood Care Coordination ● 211 LA launched Early Childhood Care Coordination in 2009 with funding from the WM Keck Foundation and the Robert Wood Johnson Foundation ● Over 7,000 Children have received Care Coordination ● 60% of children enrolled in 211 LA’s Care Coordination complete early intervention services compared to 38.8% who completed diagnostic evaluation for services in Guevara, 2012 study
  19. 19. 19 Gap between Identification and Interventions: Developmental Concerns ● In 2011 and 2012 only 2% to 3% of children in the US received Early Intervention services under IDEA when 12% are diagnosed with any developmental disability between 3 and 10 years of age and 16% between 11 and 17 years ( ● Mental health disorders emerge in 21% of children between 9 and 17 years (US Department of Health and Human Services: A report of the Surgeon General). ● Percentage of identified and served is unacceptable given the assortment of interventions and supports proven to improve developmental outcomes for children. (Early Childhood Technical Assistance Center, January 5, 2015)
  20. 20. 20 Gap Between Identification and Interventions: Autism Spectrum Disorder High Incidence of Autism - Ineffective Early Intervention ● Incidence of autism 1 in 59 reported by CDC ● Average age of identification remains at 4 years of age ● Autism can be reliably identified at 18 months of age Most children with autism are missing out on the government funded Early Intervention Services that have proven to have tremendous impact on the developmental outcomes of children with autism
  21. 21. 21 Missing the Mark ● Screening on its own does not improve children’s outcomes ● Many parents struggle with follow up and connecting to the complex system of services that are proven to improve outcomes ● Screening for developmental problems must be followed by support and further intervention to facilitate referral completion. (Guevara, Pediatrics 2013; 131:30-37 - Effectiveness of Developmental Screening in an Urban Setting).
  22. 22. Audience Polling Question: Do you have the capacity and infrastructure in your practice to document follow-up on whether children receive the needed services following an at-risk screening result? a. Yes b. No 22
  23. 23. 23 211 LA Care Coordination: Hitting the Mark 211 LA’s Specialized Early Childhood Care Coordination has proven in peer-reviewed research to increase the timeliness and effectiveness of early intervention services post- screening 211 LA Program uses a Find-Treat-Measure Approach: ● FIND- Uses the BabyNoggin screening results to match-up children with at-risk screenings with needed services ● TREAT- A Care Plan is developed identifying needed services. Assist families with obtaining the targeted early intervention and childhood services in a timely and coordinated manner – navigating with the parent hands-on the service delivery maze. ● MEASURE – track the process for eligibility of services and children actually receiving services and outcomes
  24. 24. 2 Care Coordination for At-Risk Screenings Parent receives email with 211 LA Care Coordination Offer Offer includes: 1) Consultation and care plan development 2) Concierge Care Coordination Service: care plan + ongoing support through interventions Parent signs up and pays online Online form includes: 1) Service details 2) Parent release of screening results 3) Electronic payment Connect with 211 LA Care Coordinator Live Connection: 1) During business hours and upon Care Coordinator Specialist availability 2) Contacted by next business day Outcomes Data Outcomes: 1) Parent receives outcomes data 2) With consent, outcomes data shared exclusively with medical provider Deliver Care Coordination Care Plan Consultation 1) Develop Care Plan with identified local intervention services and supports Concierge CC 1. Care Plan + hands on support, connection, coaching and advocacy on family’s behalf through obtaining interventions Atriskscreeningresult
  25. 25. Care Coordination Benefits ● Overcome missed opportunities for early intervention ● Demonstrate improvement in social and emotional skills ● Treatment cost savings (save up to $203,000/child) ● Parent education and engagement 25