State Medicaid programs remain the most important part of the public safety net of health services available to low-income children. The Fund, through its Assuring Better Child Health and Development (ABCD) initiative, has partnered with states to improve and expand the preventive care and developmental services provided to Medicaid children—and to test innovative approaches for changing practice and provider behaviors. ABCD is currently working with states to promote children's healthy mental development.

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hild Development and Preventive Care Program seeks to encourage, support, and sustain improvements in child development and preventive care for young children. The program pursues three principal strategies:
promoting the establishment of standards of care and use of these standards in quality measurement and monitoring.
identifying and disseminating models of pediatric practice that enhance the efficiency and effectiveness of care provided.
encouraging reforms that remove barriers to quality care and align provider incentives with desired clinical practices.
Children's success both in school and later in life depends on the quality of their early experiences and the ability of their parents and caretakers to anticipate and meet their developmental needs. Through regular contact with parents and young children, child health care providers can foster positive parenting behaviors, help to promote optimal development, and initiate early intervention when problems appear imminent.
In the United States, the quality of preventive care—commonly referred to as well-child care—is highly variable. Despite the commitment of considerable time and resources by physicians and other child health professionals, too many children and their families do not get the care they need. Research studies find that fewer than half attend the well-child visits recommended by national guidelines, even when financial barriers are absent. Minority or economically disadvantaged parents are two to four times more likely than their white, insured, and more affluent counterparts to be dissatisfied with their children's care, especially that related to growth and development. And nearly all parents report having unmet needs for parenting guidance, education, or screening by a pediatric professional.(1)
Pediatricians themselves report an array of obstacles to providing quality well-child care: time constraints, low levels of reimbursement for preventive pediatric care, lack of training in child development and limited access to community support services for patients, as well as few external incentives.(2)
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Edward L. Schor, M.D.
Vice President
Melinda K. Abrams
Senior Program Officer