Today, the Centers
for Medicare & Medicaid Services (CMS) released preliminary Medicaid
and Children’s Health Insurance Program (CHIP) data revealing that, during
the coronavirus disease 2019 (COVID-19) public health emergency (PHE),
rates for vaccinations, primary, and preventive services among children in
Medicaid and CHIP have steeply declined. This decline may have significant
impacts on long-term health outcomes for children, as Medicaid and CHIP
cover nearly 40 million children, including three quarters of children
living in poverty and many with special health care needs that require
health services. Further, as many schools remain closed for in-person
instruction, many of the key services children receive may be delayed, such
as child screens and vaccinations prior to the start of the school year or
in-school services such as speech therapy, physical therapy, and occupational
therapy. Because preventative and routine healthcare is crucial to ensuring
that children stay healthy, CMS is releasing this preliminary data to raise
awareness of the vital services Medicaid and CHIP provides, and calling on
stakeholders to take action to make services more readily available so that
we can begin closing the gap in care for children.
A recent CMS data
analysis reveals that, compared to the same time period in 2019, there was
a significant decline in critical primary and time-sensitive preventative
services for children between March and May. Specifically, during this
timeframe, there were 22 percent fewer (1.7 million) vaccinations received
by beneficiaries up to age 2, 44 percent fewer (3.2 million) child
screening services that assess physical and cognitive development and can
provide early detection of autism and developmental delay, among other
conditions, even after accounting for the increased use of telehealth, and
69 percent fewer (7.6 million) dental services. Although this analysis only
focuses on data through May 2020 because of the natural lag between when a
service occurs and when CMS receives data, the precipitous decline in
services remains a cause for concern. Not only must state and local
agencies, providers, schools and other key stakeholders work on returning
to prior year treatment levels, they must also strive to treat the millions
of children who have already missed important medical services.
This is essential, as
missing these services can have long-term negative impacts on children’s
health outcomes.
“As a mother, I have
witnessed first-hand how important early and regular access to screening
and medical care is for children’s development,” says CMS Administrator
Seema Verma. “The absence of these vital health care services may have
lifelong consequences for these vulnerable children, and I call on states,
pediatric providers, families, and schools to ensure children catch-up on
overdue medical, behavioral health and dental appointments as well as
childhood immunizations.”
Since the national
emergency declared in March 2020, CMS has taken swift action nationwide to
aggressively respond to COVID-19 and to work with our state partners to
provide Medicaid and CHIP programs the flexibilities they need to combat
COVID-19 locally. CMS has collaborated closely with states to quickly
provide the flexibilities needed to respond to the PHE, approving more than
500 state requests for waivers, state plan amendments, and other
flexibilities during the PHE. CMS has also encouraged states to consider
telehealth options as a flexibility in combatting the COVID-19 pandemic and
increasing access to care. Preliminary data shows that while service
delivery via telehealth for children has increased dramatically, it is
still not enough to offset this decline in care for vulnerable children.
Further, although telehealth remains an important part of care delivery for
children, some services, such as vaccinations, cannot be provided through
this vehicle, which contributes to the current gap in their healthcare.
While national data
show that vaccination rates are increasing, the number of vaccines that
have been administered so far this year have yet to make up for the large
decline earlier in the year. To ensure that children catch up on their
missed vaccines we need vaccination rates to not only approach those of
2019, but to be much higher, in order to mitigate the 22 percent dip during
the early part of the COVID-19 PHE. This has not begun to happen, and
increases the risk of transmission of vaccine-preventable illnesses, such
as measles, mumps, and Haemophilus influenza. The potential for increased
outbreaks of infectious disease due to decreased vaccinations is real, and
can result in decreased school attendance, decreased learning, and
increased childhood illness in general.
Although the start of
the school season will be different for children as many begin their
education in a virtual manner, the critical need for children to receive
preventative and routine healthcare persists. It is important for schools
and families to catch up on well-child visits and ensure that children are
up-to-date on their immunizations.
To learn more about
this announcement:
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