Access and Service Use by Children with Autism Spectrum Disorders in Medicaid Managed Care

Abstract

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.

Participation of underrepresented minority children in clinical trials for Fragile X syndrome and other neurodevelopmental disorders

“…Single parents may also find it impossible to participate in such trials. Findings from ASD studies report that URM families with a child with ASD experience more difficulties accessing services than Whites (17)(18)(19). However, the findings from our study reported otherwise.…”

Medical Care Burden of Children with Autism Spectrum Disorders

“…In general, children with ASD are an under-identified and underserved group of children whose behavioral health needs are unmet (Ruble et al 2005). Behavioral therapy accounted for the largest proportion of health expenses (54.3 %) for ASD children in China (Wang et al 2012).…”

Beyond an Autism Diagnosis: Children’s Functional Independence and Parents’ Unmet Needs

“…This is in part due to the apparent increase in the prevalence of ASD (Blaxill 2004). While there is controversy around whether this trend is due to an increase in awareness, changes in diagnostic practices, or a true increase in ASD (Fombonne 2005), the heightened demand for autism services is clear (Ruble et al 2005). The resulting strain on the service system has led to an interest in issues of unmet need.…”