Improving Follow-Up After Screening Newborns Approximately 95% of infants are being screened for hearing loss today, compared with only 3% just 15 years ago. But this improvement in Early Hearing Detection and Intervention (EHDI) screening has yet to produce comparable positive outcomes for follow-up services. In some states, one-half of those infants who fail their ... Features
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Features  |   October 01, 2005
Improving Follow-Up After Screening Newborns
Author Notes
  • Maureen Thompson, is director, private health plans advocacy at ASHA. Contact her at mthompson@asha.org.
    Maureen Thompson, is director, private health plans advocacy at ASHA. Contact her at mthompson@asha.org.×
Article Information
Hearing Disorders / Special Populations / Early Identification & Intervention / Features
Features   |   October 01, 2005
Improving Follow-Up After Screening Newborns
The ASHA Leader, October 2005, Vol. 10, 4. doi:10.1044/leader.FTR1.10142005.4
The ASHA Leader, October 2005, Vol. 10, 4. doi:10.1044/leader.FTR1.10142005.4
Approximately 95% of infants are being screened for hearing loss today, compared with only 3% just 15 years ago. But this improvement in Early Hearing Detection and Intervention (EHDI) screening has yet to produce comparable positive outcomes for follow-up services. In some states, one-half of those infants who fail their hearing screening are lost to follow-up before diagnosis and intervention.
A meeting, “Strategic Directions for Achieving National Objectives for Medicaid-Insured Children with Hearing Loss,” hosted by the National Center for Hearing Assessment and Management (NCHAM) and the Maternal and Child Health Policy Research Center, held July 12–13 in Salt Lake City addressed the issue. The meeting brought together key people from targeted state Medicaid and EHDI programs to identify strategies for effective follow-up services for children insured by Medicaid.
The meeting’s focus on children insured by Medicaid stems from the fact that one-third of the infants born in the United States are covered by the program and while 51% of the individuals served by Medicaid are children, only 15% of these funds are spent on children.
In addition to difficulties in navigating the Medicaid system, participants cited various reasons for insufficient follow-up after the initial hearing screening for infants identified with hearing loss. These include a shortage of qualified pediatric audiologists, program administration that varies from state to state, and a lack of appropriate referrals by physicians.
Karl R. White, director of NCHAM, noted that earlier identification of hearing loss and auditory input prevents connections in the brain from atrophying and thus leads to better brain development. Despite the positive results of early hearing screening, infants are not receiving appropriate follow-up services from Medicaid or the Early and Periodic Screening, Diagnostic, and Treatment programs (EPSDT).
White discussed the need to enhance information and education by sharing ideas about effectively educating primary care physicians, families, hospitals, managed care organizations, and local health departments and examining opportunities for informing and involving key stakeholders. He also talked about improving quality and financial incentives by reviewing potential opportunities for incorporating national benchmarks from Healthy People 2010, examining Medicaid reimbursement levels for hearing services, and considering alternative performance incentive strategies.
The “1/3/6” model was promoted. That is, screening a newborn’s hearing by one month of age, diagnosis of hearing loss by three months, and enrollment in an early intervention program by six months. Attendees said that most pediatricians do not refer families to the appropriate services (e.g., genetics, vision, ENT) when a patient presents with hearing loss, and most physicians don’t know that babies can be fit with amplification within days of birth-both of which have made adherence to this model difficult.
Attendees also discussed strategies for outreach, dissemination, and replication with other state Medicaid agencies and EHDI programs.
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October 2005
Volume 10, Issue 14