Unraveling EPSDT and Pediatric Hospice Care: An Exploratory Policy Analysis

Title

Unraveling EPSDT and Pediatric Hospice Care: An Exploratory Policy Analysis

Creator

Lindley LC; Weaver MS

Publisher

American Journal of Hospice and Palliative Care

Date

2022

Subject

Early and Periodic Screening Diagnosis and Treatment; Medicaid; Pediatric concurrent hospice care; Pediatric hospice care

Description

Background: Medicaid is the most common of health care benefits for children at end of life. Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) presents a complex policy scenario for children enrolled in the Medicaid hospice benefit, and specifically concurrent hospice care. Objective(s): The study purpose was to identify policy guidance on EPSDT and pediatric hospice care from state Medicaid documents. Method(s): We conducted a descriptive exploratory study, using state-level Medicaid hospice documents. Manuals, policy transmittals, provider memos, policy updates, and other related documents were searched from 50 states and the District of Columbia. We created a comprehensive data extraction tool that enabled us to identify EPSDT-specific information. The appraisal of the documents was conducted under 3 main a priori themes: definitions, function, and administration. Result(s): Eleven states included EPSDT in their hospice documentation. Definitions for concurrent care and palliative care were sparse and inconsistent. Four states defined medically necessary criterion. Several states did not integrate EPSDT into the hospice or concurrent care benefit, while EPSDT functioned as part of the Medicaid hospice benefit in 3 states and another 4 included it in their concurrent hospice care program. Among all the states, procedures for EPSDT program administration varied widely, including care coordination and payment. Conclusion(s): We found significant variation in state documents on EPSDT and pediatric hospice care. Clear guidelines and consistent standards regarding EPSDT services and how they interface with hospice, concurrent hospice care, and palliative care would improve care for children and families.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation List Month

June 2022 List

Collection

Citation

Lindley LC; Weaver MS, “Unraveling EPSDT and Pediatric Hospice Care: An Exploratory Policy Analysis,” Pediatric Palliative Care Library, accessed March 29, 2024, https://pedpalascnetlibrary.omeka.net/items/show/17930.