By Judith S. Palfrey, MD, FAAP
President, American Academy of Pediatrics
On Wednesday, I was honored to attend an event in DC
unveiling the US Department of Health and Human Services’ (HHS) Interim Final
Rule on preventive services under health reform. To so many of us in the
business of taking care of children, the achievement of passing the law last
March was a time of historic celebration, and now, as one of the most
significant pieces of the law takes shape, we realize just how much better off
our children will be under health reform.
One of the earliest provisions of the Patient Protection
and Affordable Care Act to take effect is Section 2713, which requires health
plans to cover, at absolutely no out-of-pocket cost to families, preventive
care services outlined in Bright Futures: Guidelines for Health Supervision of
Infants, Children, and Adolescents. Supported by the Health Resources and
Services Administration, Bright Futures is the definitive standard of pediatric
well-child and preventive care developed by an evidence-informed, active
collaboration led by the American Academy of Pediatrics (AAP).
Perhaps the best-known aspect of Bright Futures is the
schedule of “well-baby and well-child visits” it establishes–31 visits between
birth and age 21 years (to pediatricians and other clinicians, it is also known
as the “periodicity schedule“). The interim rule clearly states that all
components of pediatric well-child visits–including physical exams,
immunizations, hearing and vision screening, developmental and behavioral
screening, and anticipatory guidance–in accordance with the Bright Futures
periodicity schedule must be free of financial barriers, including co-pays and
deductibles. Insurers may not exclude any of these services from coverage, and
cost-sharing cannot be imposed on families.
This landmark investment in preventive services will
eventually allow all families, regardless of income, the opportunity to visit
their pediatrician regularly during their children’s most critical years of
development. Having coverage for the clinically appropriate well-child visits
will allow pediatricians to identify and treat health problems in children
before they start. This, in turn, should help bring down the prevalence of
chronic conditions that place significant financial and physical strain on
children and families.
The Academy will continue to work with HHS on the
development of a Final Rule, and in the process, will continue to advocate for
the following: all plans–including those retaining “grandfather
status”–to cover Bright Futures services; Bright Futures to be
appropriately integrated into other initiatives and standards, such as
meaningful use and quality measures; and for insurance companies to eliminate
cost-sharing while making up those dollars for pediatricians and other health
The views expressed by Guest Bloggers do not necessarily reflect the views of the Center for Children and Families.
Editor’s Note: CCF’s Dawn Horner also blogged about the preventive health services rule.