• This is a Healthcare Effectiveness & Data Information Set (HEDIS®) administrative measure and only includes Medicaid Primary beneficiaries.
• The annual reported rate captures activity during the stated measurement year (MY).
• The target trendline in the graph above represents the 90th national benchmark percentile for Medicaid programs across the country. Benchmarks became available for this measure in 2022 for reporting year 2021. 

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.

This measure assesses the percentage of members who had the following number of well-child visits with a PCP during the last 15 months. The following rates are reported:

1.  Well-Child Visits in the First 15 Months. Children who turned 15 months old during the measurement year: Six or more well-child visits.

2.  Well-Child Visits for Age 15 Months–30 Months. Children who turned 30 months old during the measurement year: Two or more well-child visits.

This measure is based on the American Academy of Pediatrics Bright Futures guidelines for Health Supervision of Infants, Children and Adolescents.  In addition to the Bright Futures Guidelines, the AP publishes a recommended schedule of screenings and assessments, known as the periodicity schedule, that outlines what to do at every visit, from infancy to adolescence.  Bright Futures recommends more frequent well-child visits in the first years of life and one or more annual well-child visits from age 3–21. They recommend that the well-child visits include, but are not limited to, an initial/interval medical history, physical exam, developmental assessment, immunization and anticipatory guidance.

A total of eight well-care visits is recommended from the time the child is born to the time he or she reaches 15 months old. The visits that occur before the 15 month birthday are of particular importance because this is the period when an infant undergoes substantial changes in abilities, physical growth, motor skills, hand-eye coordination and social and emotional growth. They are foundational to preventive health care, such as evidence-based screenings and immunizations, because they promote better social, developmental and health outcomes.

The AAP/Bright Futures guidelines also recommend two or more visits between 15 months and 30 months, an important period for early assessment and screenings.  Early identification of developmental disorders is critical to the well-being of children and their families.  It is an integral function of the primary care medical home and an appropriate responsibility of all pediatric health care professionals.  Research shows that early intervention treatment services can greatly improve a child’s development. Early intervention services help children from birth through 3 years of age (36 months) learn important skills.

Last updated:  September 2021

NCQA’s Notice of Copyright and Disclaimers 
“The source for certain health plan measure rates and benchmark (averages and percentiles) data (“the Data”) is Quality Compass® 2022 and is used with the permission of the National Committee for Quality Assurance (“NCQA”). Any analysis, interpretation or conclusion based on the Data is solely that of the authors, and NCQA specifically disclaims responsibility for any such analysis, interpretation or conclusion. Quality Compass is a registered trademark of NCQA. 

The Data comprises audited performance rates and associated benchmarks for Healthcare Effectiveness Data and Information Set measures (“HEDIS® ”) and HEDIS CAHPS® survey measure results. HEDIS measures and specifications were developed by and are owned by NCQA. HEDIS measures and specifications are not clinical guidelines and do not establish standards of medical care. NCQA makes no representations, warranties or endorsement about the quality of any organization or clinician that uses or reports performance measures or any data or rates calculated using HEDIS measures and specifications, and NCQA has no liability to anyone who relies on such measures or specifications. 

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