their health status. While EPSDT is a primary reason for improvements in the health, barriers to care beyond coverage inhibit the potential of this benefit. A number of studies have documented low performance of EPSDT programs in some states or communities. This includes the US Government Accountability Office, which has conducted a series of studies of EPSDT over the years. In a 2010 report, the U.S. Health and Human Services Inspector General found that three out of four children did not receive all required medical, vision and hearing screenings under EPSDT. Moreover, nearly 60 percent of the children in selected states who had an EPSDT screening visit did not receive all five required components of the visit. Lab tests were most often missing. By promoting and vigorously implementing the EPSDT program and its various components, states can improve the quality of health care, reduce the prevalence of preventable conditions, and have measurable impact. A series of 18 state leadership workshops on EPSDT identified key actions states can take to improve services, coordination, and administration. State reports, research, and federal recommendations together point to several general approaches that states can use to reduce barriers and improve EPSDT. These are beyond efforts to ensure that eligible children are enrolled in Medicaid, and, where appropriate, connected to a managed care plan or medical home. First, every state should adopt a periodic visit (periodicity) schedule that conforms to the model of the American Academy of Pediatrics. The visit content should conform to the Bright Futures guidelines. These professional guidelines are based on the best available evidence regarding what works for children in pediatric care and what can be achieved through well-child visits. Second, states should clearly communicate to families and providers regarding the range of services covered. Federal law requires that states adequately inform parents about the benefits of EPSDT. Some states’ communications with parents have often focused primarily on screening and provided limited information regarding the range of treatment and intervention services that may be covered when medically necessary. In particular, offering training, clear provider manuals, specific website content, and routine communication can assist providers in delivering high-quality well-child visits financed through EPSDT, as well as visits financed by other payer sources. Third, improving the quality and structure of services. Quality improvement projects and efforts to accurately measure program performance are important. Equally important is maximizing the available health professionals, including an array