Access and service use by children with autism spectrum disorders in Medicaid Managed Care

J Autism Dev Disord. 2005 Feb;35(1):3-13. doi: 10.1007/s10803-004-1026-6.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Autistic Disorder / epidemiology*
  • Autistic Disorder / therapy
  • Behavior Therapy / statistics & numerical data*
  • Behavior Therapy / trends
  • Case Management / statistics & numerical data
  • Case Management / trends
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Day Care, Medical / statistics & numerical data
  • Day Care, Medical / trends
  • Female
  • Forecasting
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Accessibility / trends
  • Humans
  • Incidence
  • Male
  • Managed Care Programs / statistics & numerical data*
  • Managed Care Programs / trends
  • Medicaid / statistics & numerical data*
  • Medicaid / trends
  • Mental Health Services / statistics & numerical data*
  • Mental Health Services / trends
  • Psychotropic Drugs / therapeutic use
  • State Health Plans / statistics & numerical data
  • Tennessee
  • United States
  • Utilization Review / statistics & numerical data


  • Psychotropic Drugs