A report released by the Government Accountability Office (GAO) in August concluded that preventative care is lacking under state Medicaid programs.  The report found that Medicaid-insured children are at special risk for certain health conditions, including obesity, and that an estimated 41 percent of those children did not receive a well-child check up over a two-year period.  In addition, the GAO found that preventative care for Medicaid-insured adults varies widely by service and state, with 93 percent of adults receiving blood pressure screenings but only 41 percent potential candidates receiving colorectal screenings.  The GAO recommends that the Centers for Medicare & Medicaid Services (CMS) ensure that state’s Early Periodic Screening, Diagnostic, and Treatment (EPSDT) programs are reviewed regularly and that the agency expedite its efforts to provide guidance to states on obesity-related services for children.  The GAO also suggests that CMS provide similar guidance for adult preventative services.

From the report:

Nationally representative data suggest that a large proportion of children and adults in Medicaid have certain health conditions, particularly obesity, that can be identified or managed by preventive services, and adults’ receipt of preventive services varies widely. For Medicaid children, NHANES data from 1999 through 2006 suggest that 18 percent of children aged 2 through 20 were obese, 4 percent of children aged 8 through 20 had high blood pressure, and 10 percent of children aged 6 through 20 had high cholesterol. Furthermore, MEPS data from 2003 through 2006 suggest that many Medicaid children were not receiving well-child check ups. For Medicaid adults aged 21 through 64, NHANES data suggest that more than half were obese or had diabetes, high cholesterol, high blood pressure, or a combination. MEPS data suggest that receipt of preventive services varied widely by service: receipt of some services, such as blood pressure tests, was high, but receipt of several other services was low. MEPS data also suggest that a lower percentage of Medicaid adults received preventive services compared to privately insured adults.

Full report: Medicaid Preventive Services: Concerted Efforts Needed to Ensure Beneficiaries Receive Services (PDF | 1.3 MB)

Government Accountability Office. (2009). Medicaid preventive services: Concerted efforts needed to ensure beneficiaries receive services. Cackley, A.P., Iritani, K.M., Beller, E., Bloch, S., Deyo, E., Henderson, E., Kelly, M., Tam, T. and Tewarson, H.