Datapoints: Medicaid's Increasing Role in Treating Youths With Autism Spectrum Disorders

University of Pennsylvania School of Medicine, 3535 Market St., Philadelphia, PA 19104, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 06/2011; 62(6):588. DOI: 10.1176/
Source: PubMed
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Available from: David S Mandell
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    ABSTRACT: Healthcare costs and service use for autism spectrum disorder (ASD) were compared between Medicaid and private insurance, using 2003 insurance claims data in 24 states. In terms of costs and service use per child with ASD, Medicaid had higher total healthcare costs ($22,653 vs. $5,254), higher ASD-specific costs ($7,438 vs. $928), higher psychotropic medication costs($1,468 vs. $875), more speech therapy visits (13.0 vs. 3.6 visits), more occupational/physical therapy visits (6.4 vs. 0.9 visits), and more behavior modification/social skills visits (3.8 vs. 1.1 visits) than private insurance (all p < 0.0001). In multivariate analysis, being enrolled in Medicaid had the largest effect on costs, after controlling for other variables. The findings emphasize the need for continued efforts to improve private insurance coverage of autism.
    No preview · Article · Sep 2012 · Journal of Autism and Developmental Disorders
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    ABSTRACT: The rise in the prevalence of autism spectrum disorder (ASD) has resulted in increased efforts to understand the causes of this complex set of disorders that emerge early in childhood. Although research in this area is underway and yielding useful, but complex information about ASD, guidelines for the use of genetic testing and counseling among children with ASD conflict. The purpose of this study was to determine the frequency of use of genetic testing and counseling before the widespread implementation of clinical chromosomal microarray (CMA) to establish a baseline for the use of both services and to investigate potential disparities in the use of both services among children with ASD. We found that about two-thirds of children with ASD received genetic testing or counseling and the use of both services is increasing with time, even in the pre-CMA era. Being female and having a comorbid intellectual disability diagnosis both increased the likelihood of receiving genetic testing and genetic counseling. Initial discrepancies in the use of both services based on race/ethnicity suggest that troubling disparities observed in other services delivered to children with ASD and other mental health disorders persist in genetic testing and counseling as well. These results should incentivize further investigation of the impact of genetic testing and counseling on children with ASD and their families, and should drive efforts to explore and confront disparities in the delivery of these services, particularly with the advancing scientific research on this topic.
    No preview · Article · Sep 2013 · Human Genetics
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    ABSTRACT: Objective: This study examined the extent to which state Medicaid agencies funded 16 services for children with autism spectrum disorders: individual therapy, physical and occupational therapy, in-home supports, speech therapy, diagnostic assessment, behavior modification, family therapy, case management, targeted case management, respite, day treatment, social skills training, habilitation services, treatment planning, family education and training, and assistive communication devices. Methods: Procedure codes in the Medicaid Analytic eXtract (MAX) "other therapies" file were used to identify community-based services commonly delivered to children with a diagnosis of a primary autism spectrum disorder. Results: Four services are commonly used to address the core deficits of these disorders: physical and occupational therapy, speech therapy, behavior modification, and social skills training. Only six states funded all four services. Conclusions: States varied considerably in use of Medicaid to reimburse these services, indicating that some states may have opportunities to receive federal matching funds.
    Full-text · Article · Oct 2013 · Psychiatric services (Washington, D.C.)
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