Access and service use by children with autism spectrum disorders in Medicaid Managed Care.
Although Medicaid is the largest public payer of behavioral health services, information on access and utilization of services is lacking, and no data on the frequency of service use or types of services provided for children with autism spectrum disorders (ASDs) are available. As states move toward managed care approaches for their Medicaid program, services information is critical. Behavioral health service data for children with autism spectrum disorders were collected from a state Medicaid Managed Care (MMC) program and analyzed from fiscal years 1995 through 2000. Findings revealed that the number of children who received services over time increased significantly; however, the rate of service use was only one tenth of what should be expected based on prevalence rates. The mean number of service days provided per child decreased significantly, about 40%, and the most prevalent forms of treatment changed. Day treatment vanished and medication and case management increased disproportionately to the number of children served. Explanations and implications of the findings are presented as well as recommendations for future research.
Ruble
Lisa A
LA
Department of Pediatrics, Weisskopf Center for the Evaluation of Children, University of Louisville, KY 40202, USA. lisa.ruble@louisville.edu
Heflinger
Craig Anne
CA
Renfrew
J William
JW
Saunders
Robert C
RC
D001321:Autistic Disorder / Q000453:epidemiology* / Q000628:therapy; D001521:Behavior Therapy / Q000706:statistics & numerical data* / Q000639:trends; D019090:Case Management / Q000706:statistics & numerical data / Q000639:trends; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003631:Day Care, Medical / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005544:Forecasting; D006297:Health Services Accessibility / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data* / Q000639:trends; D008484:Medicaid / Q000706:statistics & numerical data* / Q000639:trends; D008605:Mental Health Services / Q000706:statistics & numerical data* / Q000639:trends; D011619:Psychotropic Drugs / Q000627:therapeutic use; D013221:State Health Plans / Q000706:statistics & numerical data; D013714:Tennessee; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data
D011619:Psychotropic Drugs