Indiana

Improving Blood Lead Testing Compliance Among Medicaid-Covered Children in Indiana

Through a statewide data-driven initiative, Indiana increased blood lead testing rates among Medicaid-covered children from 49% in January 2024 to 58% by March 2025 — a nearly 9% increase statewide. This achievement came in response to a troubling gap: despite Medicaid requiring blood lead screening for all enrolled children at 12 and 24 months, a 2024 analysis by the Indiana Department of Health (IDOH) revealed that only 49% of Medicaid-covered children ages 1–6 had received at least one blood lead test. To understand and address this gap, IDOH partnered with the Office of Family and Social Services Administration to cross-reference monthly testing files with Medicaid enrollment data, enabling the development of a statewide compliance rate and identifying which children under each provider's care had yet to be tested.

Equipped with this data, IDOH launched a statewide outreach initiative in early 2024, meeting with all 95 local health departments (LHDs) across Indiana. Each LHD received county-specific compliance data and was asked to identify providers in their area. IDOH then generated over 60 individualized reports for medical offices, showing provider-level detail on which Medicaid-covered children still needed a blood lead test. This approach leveraged the trusted relationships LHDs already had with local providers to drive meaningful action at the community level.

All 95 counties expressed interest in receiving ongoing provider-level data, and standout partners like Allen and Bartholomew Counties took proactive steps to track provider performance, identify billing discrepancies, and establish direct communication channels with pediatric and family practice offices. Indiana's data-driven, relationship-centered model offers a replicable blueprint for improving lead testing compliance.