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Healthcare Service Use and Costs for Autism Spectrum Disorder: A Comparison Between Medicaid and Private Insurance / Li WANG in Journal of Autism and Developmental Disorders, 43-5 (May 2013)
[article]
Titre : Healthcare Service Use and Costs for Autism Spectrum Disorder: A Comparison Between Medicaid and Private Insurance Type de document : Texte imprimé et/ou numérique Auteurs : Li WANG, Auteur ; David S. MANDELL, Auteur ; Lindsay LAWER, Auteur ; Zuleyha CIDAV, Auteur ; Douglas L. LESLIE, Auteur Article en page(s) : p.1057-1064 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder Children Healthcare costs Service use Medicaid Private insurance Index. décimale : PER Périodiques Résumé : 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 (22,653vs. 5,254), higher ASD-specific costs (7,438vs. 928), higher psychotropic medication costs(1,468vs. 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. En ligne : http://dx.doi.org/10.1007/s10803-012-1649-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=195
in Journal of Autism and Developmental Disorders > 43-5 (May 2013) . - p.1057-1064[article] Healthcare Service Use and Costs for Autism Spectrum Disorder: A Comparison Between Medicaid and Private Insurance [Texte imprimé et/ou numérique] / Li WANG, Auteur ; David S. MANDELL, Auteur ; Lindsay LAWER, Auteur ; Zuleyha CIDAV, Auteur ; Douglas L. LESLIE, Auteur . - p.1057-1064.
Langues : Anglais (eng)
in Journal of Autism and Developmental Disorders > 43-5 (May 2013) . - p.1057-1064
Mots-clés : Autism spectrum disorder Children Healthcare costs Service use Medicaid Private insurance Index. décimale : PER Périodiques Résumé : 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 (22,653vs. 5,254), higher ASD-specific costs (7,438vs. 928), higher psychotropic medication costs(1,468vs. 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. En ligne : http://dx.doi.org/10.1007/s10803-012-1649-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=195 Changes in healthcare expenditures after the autism insurance mandate / Li WANG in Research in Autism Spectrum Disorders, 57 (January 2019)
[article]
Titre : Changes in healthcare expenditures after the autism insurance mandate Type de document : Texte imprimé et/ou numérique Auteurs : Li WANG, Auteur ; Junyi MA, Auteur ; Ruchita DHOLAKIA, Auteur ; Callie HOWELLS, Auteur ; Yun LU, Auteur ; Chen CHEN, Auteur ; Runze LI, Auteur ; Michael MURRAY, Auteur ; Douglas LESLIE, Auteur Article en page(s) : p.97-104 Langues : Anglais (eng) Mots-clés : Autism mandate Healthcare expenditures Cost Autism spectrum disorder Private insurance Index. décimale : PER Périodiques Résumé : Background In recent years, most U.S. states have passed autism mandates requiring private insurers to cover autism spectrum disorders (ASD). Little is known about the post-mandate changes in healthcare expenditures. Method This study utilized 2006–2012 de-identified insurance claims data from the largest private insurer in Pennsylvania (PA), where the mandate went into effect in mid 2009. Healthcare expenditures were defined as the amount the insurer paid for healthcare services and were adjusted to 2012 price level. A mixed effects model was used to analyze the expenditures. Results A total of 9471 children with ASD were included. Although the pre-mandate total expenditures per child with ASD were similar, the post-mandate expenditures significantly increased for groups subject to the autism mandate (87% increase from $7754 in 2008 to $14,486 in 2010) compared to the exempt groups (27% increase from $7238 to $9171). By insurance type, the change from 2008 to 2010 in ASD-related expenditures per child with ASD was $8439 for fully insured large employer sponsored plans and $43 for the Children’s Health Insurance Program (CHIP), both subject to the PA mandate; and $2631 for the self-insured, $980 for small-employers, and $-92 for individual plans, all of which are exempt from the mandate. These increases were due to outpatient services but not inpatient or drug costs. Conclusions Healthcare expenditures increased significantly following the PA autism mandate. Nonexempt, large employer groups had the largest increase in spending. Some exempt, self-insured companies may have voluntarily covered ASD services, leading to a moderate increase. En ligne : https://doi.org/10.1016/j.rasd.2018.10.004 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371
in Research in Autism Spectrum Disorders > 57 (January 2019) . - p.97-104[article] Changes in healthcare expenditures after the autism insurance mandate [Texte imprimé et/ou numérique] / Li WANG, Auteur ; Junyi MA, Auteur ; Ruchita DHOLAKIA, Auteur ; Callie HOWELLS, Auteur ; Yun LU, Auteur ; Chen CHEN, Auteur ; Runze LI, Auteur ; Michael MURRAY, Auteur ; Douglas LESLIE, Auteur . - p.97-104.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 57 (January 2019) . - p.97-104
Mots-clés : Autism mandate Healthcare expenditures Cost Autism spectrum disorder Private insurance Index. décimale : PER Périodiques Résumé : Background In recent years, most U.S. states have passed autism mandates requiring private insurers to cover autism spectrum disorders (ASD). Little is known about the post-mandate changes in healthcare expenditures. Method This study utilized 2006–2012 de-identified insurance claims data from the largest private insurer in Pennsylvania (PA), where the mandate went into effect in mid 2009. Healthcare expenditures were defined as the amount the insurer paid for healthcare services and were adjusted to 2012 price level. A mixed effects model was used to analyze the expenditures. Results A total of 9471 children with ASD were included. Although the pre-mandate total expenditures per child with ASD were similar, the post-mandate expenditures significantly increased for groups subject to the autism mandate (87% increase from $7754 in 2008 to $14,486 in 2010) compared to the exempt groups (27% increase from $7238 to $9171). By insurance type, the change from 2008 to 2010 in ASD-related expenditures per child with ASD was $8439 for fully insured large employer sponsored plans and $43 for the Children’s Health Insurance Program (CHIP), both subject to the PA mandate; and $2631 for the self-insured, $980 for small-employers, and $-92 for individual plans, all of which are exempt from the mandate. These increases were due to outpatient services but not inpatient or drug costs. Conclusions Healthcare expenditures increased significantly following the PA autism mandate. Nonexempt, large employer groups had the largest increase in spending. Some exempt, self-insured companies may have voluntarily covered ASD services, leading to a moderate increase. En ligne : https://doi.org/10.1016/j.rasd.2018.10.004 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371 Treatment patterns in children with autism in the United States / B. U. MONZ in Autism Research, 12-3 (March 2019)
[article]
Titre : Treatment patterns in children with autism in the United States Type de document : Texte imprimé et/ou numérique Auteurs : B. U. MONZ, Auteur ; R. HOUGHTON, Auteur ; K. LAW, Auteur ; G. LOSS, Auteur Article en page(s) : p.517-526 Langues : Anglais (eng) Mots-clés : Medicaid access to care autism spectrum disorder children private insurance rural service use urban Index. décimale : PER Périodiques Résumé : Children with autism receive different types of non-drug treatments. We aimed to describe caregiver-reported pattern of care and its variability by geography and healthcare coverage in a US-wide sample of children aged 3-17 years. We recruited caregivers from the Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Two online questionnaires (non-drug treatment, Autism Impact Measure) were completed in September/October 2017. Primary outcome measures were caregiver-reported types and intensities of treatments (behavioral, developmental/relationship, speech and language (SLT), occupational, psychological, "other"; parent/caregiver training) in the previous 12 months. Main explanatory variables were geography and type of healthcare coverage. We investigated associations between the type/intensity of treatments and geography (metropolitan/nonmetropolitan) or coverage (Medicaid vs privately insured by employer) using regression analysis. Caregivers (n = 5,122) were mainly mothers (92.1%) with mean (SD) age of 39.0 (7.3) years. Mean child age was 9.1 (3.9) years; mostly males (80.0%). Almost all children received at least one intervention (96.0%). Eighty percent received SLT or occupational therapy, while 52.0% received both. Behavioral therapy and SLT were significantly more frequent and more intense in metropolitan than in nonmetropolitan areas. No consistently significant associations were seen between healthcare coverage and frequency or intensity of interventions. At least one barrier such as "waiting list" and "no coverage" was reported by 44.8%. In conclusion, in children sampled from SPARK, we observed differences between metropolitan and nonmetropolitan areas, while we did not find significant differences between those privately insured versus Medicaid. Autism Res 2019, 12: 517-526 (c) 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: The American Academy of Child and Adolescent Psychiatry recommends the use of multiple treatment modalities in autism spectrum disorder (ASD). We wanted to understand what types of treatment children (aged 3-17 years) with ASD receive in the United States, how and where the treatments take place and for how long. We invited caregivers from Simons Foundation Powering Autism Research for Knowledge ("SPARK ," https://sparkforautism.org/) to complete the study questions online. Participants reported on utilization of conventional, non-drug treatments for ASD, including behavioral interventions, developmental/relationship interventions, speech and language therapy (SLT), occupational therapy, psychological therapy, and parent/caregiver training. People that completed the study (n = 5,122) were primarily mothers of the child with ASD (92%); most of the children were boys (80%). The ASD care for the child was mostly coordinating by the mother. Almost all children received at least some type of non-drug therapies (96%), most often SLT and/or occupational therapy, mainly provided in school. Behavioral therapy was most often received in public school in rural areas, while at home in urban areas. We saw less use of behavioral therapy and SLT in rural areas, but overall comparable use between children covered by Medicaid and those covered by private insurance. Almost half the caregivers reported at least one barrier to treatment, such as "waiting list" and "no coverage." More than half said that their child benefited "much" or "very much" from the therapies received. While overall non-drug treatment rates for children with ASD were high in the United States in our study, differences existed depending on where the family lives; not only regarding the type of therapy, but also where it takes place. En ligne : http://dx.doi.org/10.1002/aur.2070 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387
in Autism Research > 12-3 (March 2019) . - p.517-526[article] Treatment patterns in children with autism in the United States [Texte imprimé et/ou numérique] / B. U. MONZ, Auteur ; R. HOUGHTON, Auteur ; K. LAW, Auteur ; G. LOSS, Auteur . - p.517-526.
Langues : Anglais (eng)
in Autism Research > 12-3 (March 2019) . - p.517-526
Mots-clés : Medicaid access to care autism spectrum disorder children private insurance rural service use urban Index. décimale : PER Périodiques Résumé : Children with autism receive different types of non-drug treatments. We aimed to describe caregiver-reported pattern of care and its variability by geography and healthcare coverage in a US-wide sample of children aged 3-17 years. We recruited caregivers from the Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Two online questionnaires (non-drug treatment, Autism Impact Measure) were completed in September/October 2017. Primary outcome measures were caregiver-reported types and intensities of treatments (behavioral, developmental/relationship, speech and language (SLT), occupational, psychological, "other"; parent/caregiver training) in the previous 12 months. Main explanatory variables were geography and type of healthcare coverage. We investigated associations between the type/intensity of treatments and geography (metropolitan/nonmetropolitan) or coverage (Medicaid vs privately insured by employer) using regression analysis. Caregivers (n = 5,122) were mainly mothers (92.1%) with mean (SD) age of 39.0 (7.3) years. Mean child age was 9.1 (3.9) years; mostly males (80.0%). Almost all children received at least one intervention (96.0%). Eighty percent received SLT or occupational therapy, while 52.0% received both. Behavioral therapy and SLT were significantly more frequent and more intense in metropolitan than in nonmetropolitan areas. No consistently significant associations were seen between healthcare coverage and frequency or intensity of interventions. At least one barrier such as "waiting list" and "no coverage" was reported by 44.8%. In conclusion, in children sampled from SPARK, we observed differences between metropolitan and nonmetropolitan areas, while we did not find significant differences between those privately insured versus Medicaid. Autism Res 2019, 12: 517-526 (c) 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: The American Academy of Child and Adolescent Psychiatry recommends the use of multiple treatment modalities in autism spectrum disorder (ASD). We wanted to understand what types of treatment children (aged 3-17 years) with ASD receive in the United States, how and where the treatments take place and for how long. We invited caregivers from Simons Foundation Powering Autism Research for Knowledge ("SPARK ," https://sparkforautism.org/) to complete the study questions online. Participants reported on utilization of conventional, non-drug treatments for ASD, including behavioral interventions, developmental/relationship interventions, speech and language therapy (SLT), occupational therapy, psychological therapy, and parent/caregiver training. People that completed the study (n = 5,122) were primarily mothers of the child with ASD (92%); most of the children were boys (80%). The ASD care for the child was mostly coordinating by the mother. Almost all children received at least some type of non-drug therapies (96%), most often SLT and/or occupational therapy, mainly provided in school. Behavioral therapy was most often received in public school in rural areas, while at home in urban areas. We saw less use of behavioral therapy and SLT in rural areas, but overall comparable use between children covered by Medicaid and those covered by private insurance. Almost half the caregivers reported at least one barrier to treatment, such as "waiting list" and "no coverage." More than half said that their child benefited "much" or "very much" from the therapies received. While overall non-drug treatment rates for children with ASD were high in the United States in our study, differences existed depending on where the family lives; not only regarding the type of therapy, but also where it takes place. En ligne : http://dx.doi.org/10.1002/aur.2070 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387