19th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 8-10, 2020 • Kansas City, MO
3/10/2020 | 9:40 AM - 10:10 AM | Loss to diagnostic follow up in North Carolina: A Medicaid Claims Validation Study | Empire A
Loss to diagnostic follow up in North Carolina: A Medicaid Claims Validation Study
In North Carolina, 99.3% of infants born in the state are screened for hearing loss by one month of age. Among infants born in 2017 who did not pass initial hearing screening, 27% did not have a documented audiological evaluation recorded in the Early Hearing Detection and Intervention Information System (EHDI-IS) and were considered lost to diagnostic follow-up (LTF). Principal source of payment recorded on the birth certificate may underestimate Medicaid enrollment among EHDI infants and hinder follow-up of some LTF cases. The majority of our LTF cases occur among infants enrolled in the state Medicaid program. To assess whether these infants were lost to documentation or lost to follow-up, we examined Medicaid paid claims for audiology services.
We identified infants born in 2017 that were LTF through EHDI-IS and linked this cohort to a state database containing North Carolina resident births matched with state Medicaid enrollment and claims records to determine Medicaid enrollment at birth. We then linked infants enrolled in the Medicaid program at birth to Medicaid claims for audiological evaluation procedure codes. We considered at least one audiological billable code occurring within one year of birth as the “true measure” to differentiate loss to follow up versus loss to documentation cases. We estimated whether cases LTF in EHDI-IS were true cases or false positive cases (lost to documentation).
In 2017, 836 infants screened positive for hearing loss at initial screening in North Carolina. Among those children who did not pass initial screening, 27% of infants were categorized as LTF. Medicaid enrollment and claims linkage reveals that the majority of LTF infants were enrolled in Medicaid at birth (78.0%). Medicaid enrollees have higher rates of LTF than infants not enrolled in Medicaid.
Analyzing Medicaid enrollment and claims data can be useful tools for potentially resolving cases lost to documentation.
- Attendees will be able to explain benefits of linking EHDI-IS data to Medicaid Claims data
- Attendees will be able to describe how use of Medicaid Claims data can reduce loss to documentation
- Attendees will be able to differentiate loss to follow-up from loss to documenation
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Presenters/Authors
Marcia Fort
(), NC DHHS, marcia.fort@dhhs.nc.gov;
Dr. Fort is the Genetics and Newborn Screening Unit Manager in the Whole Child Health Section of the North Carolina Division of Child and Family Well-Being and serves as the NC EHDI Coordinator. Marcia has worked with the NC EHDI program since 2002. Dr. Fort has 32 years of experience as a pediatric audiologist in hospital, private practice, ENT office and public school settings.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Kathleen Jones-Vessey
(), NC Department of Health and Human Services, Kathleen.Jones-Vessey@dhhs.nc.gov;
Kathleen Jones-Vessey is the Maternal and Child Health Epidemiologist for the Women's and Children's Health Section of the North Carolina Division of Public Health.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
John Whisler
(), NC DPH, Early Hearing Detection and Intervention Program, john.whisler@dhhs.nc.gov;
Mr Whisler is the business analyst for the EDHI program
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Morgan Moore
(), NC DHHS, Morgan.Moore@dhhs.nc.gov;
Morgan Moore, M.S., is a Speech-Language Consultant for the North Carolina EHDI Program. She has worked with the NC EHDI program for 7 years. Prior to joining the EHDI program, she had 7 years experience as a speech-language pathologist in the North Carolina Public Schools.
ASHA DISCLOSURE:
Financial -
Nonfinancial -