06/06/22
The COVID-19 pandemic continues to disrupt routine childhood immunizations and well-child visits, according to the Centers for Disease Control and Prevention (CDC). The CDC recommends doctors and health care professionals encourage families to schedule vaccines and visits to help children catch up. We’ve created Wellness Guidelines and vaccine information for our members to may help.
Closing Care Gaps
To help monitor and improve our members’ care, we track these Healthcare Effectiveness Data and Information Set (HEDIS®) measures developed by the National Committee for Quality Assurance:
- Child Immunization Status tracks the percentage of 2-year-olds who received by their 2nd birthday a total of four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three haemophilus influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two flu vaccines.
- Immunizations for Adolescents tracks the percentage of 13-year-olds who had one dose of meningococcal vaccine; one tetanus, diphtheria and pertussis (Tdap); and the complete human papillomavirus vaccine (HPV) series by their 13th birthday.
- Well-Child Visits in the First 30 Months of Life measures the percentage of children who had six or more well-child visits with a primary care physician during their first 15 months and two or more well-child visits during their next 15 months.
Tips to Consider
- Identify members who have missed vaccines or well-child visits. Contact their caregivers to schedule appointment
- Check at each visit for any missing immunizations. Address common misconceptions about vaccines.
- To document well-child visits, note that the visit was with a PCP and include in the medical record
- Date of visit
- Health history
- Physical and mental development history
- Physical exam
- Health education or anticipatory guidance
- We collect immunization data through claims and chart review. To document immunizations, you may include in the medical record any of the following:
- Certificates of immunizations
- Diagnostic reports
- Subjective, Objective, Assessment and Plan (SOAP) notes
- Office or progress notes
Resources
- CDC recommendations on COVID-19 vaccines and boosters for children and teens
- BCBSTX preventive care guidelines on immunization schedules
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA.