ADHD treatment in a behavioral health care carve-out: Medications, providers, and service utilization
ABSTRACT Children's mental health services are increasingly being managed by managed behavioral health organizations (MBHOs) through carve-outs. Little information is available, however, about services and interventions being received by children whose mental health benefits are carved out. Using claims data, this study explores the treatment of children with a common child psychiatric disorder, attention deficit hyperactivity disorder (ADHD). Children being treated for ADHD see a variety of provider combinations. Children diagnosed with comorbid mood or anxiety disorders are more likely to see a psychiatrist than a primary care physician or therapist, and they are more likely to be in treatment with both a psychiatrist and a therapist than with just one mental health professional. After controlling for severity indicators, costs were significantly lower for patients being treated by just a psychiatrist than for patients seeing both a psychiatrist and therapist. This finding raises the possibility that attempts to save money by "splitting treatment" may not be cost-effective.
Full-textDOI: · Available from: Bradley Stein, Aug 09, 2015
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ABSTRACT: The costs associated with attention deficit hyperactivity disorder are considerable. These costs are incurred for the provision of health services, out-of-pocket family expenditures, educational services and juvenile justice services. In this review, we present the components of these costs and discuss factors likely to make a significant impact. It is shown that pharmaceuticals and ambulatory care services, in particular outpatient mental healthcare, account for the majority of healthcare costs. Finally, data are presented that suggest attention deficit hyperactivity disorder is associated with increased educational costs, while increased costs associated with juvenile justice may be due to mental health comorbidity. We speculate on future costs for attention deficit hyperactivity disorder given the introduction of new pharmaceutical agents and discuss projected increases in the prevalence of the disorder in under-represented populations.Expert Review of Pharmacoeconomics & Outcomes Research 04/2003; 3(2):201-10. DOI:10.1586/1473718.104.22.168 · 1.87 Impact Factor