Have rates of behavioral health assessment and treatment increased for Massachusetts children since the Rosie D. decision? A report from two primary care practices

Clin Pediatr (Phila). 2014 Mar;53(3):243-9. doi: 10.1177/0009922813507993. Epub 2013 Nov 11.


Following a court decision (Rosie D. v. Romney), the Medicaid program in Massachusetts launched the statewide Children's Behavioral Health Initiative in 2008 to increase the recognition and treatment of behavioral health problems in pediatrics. We reviewed billing data (n = 64,194) and electronic medical records (n = 600) for well child visits in pediatrics in 2 practices to examine rates of behavioral health screening, problem identification, and treatment among children seen during the year before and 2 years after the program's implementation. According to electronic medical records, the percentage of well child visits that included any form of behavioral health assessment increased significantly during the first 2 years of the program, and pediatricians significantly increased their use of standardized screens. According to billing data, behavioral health treatment increased significantly. These findings suggest that behavioral health screening and treatment have increased following the Rosie D. decision.

Keywords: mandatory screening; mental health; pediatrics; primary health care.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Child
  • Child Behavior Disorders / diagnosis*
  • Child, Preschool
  • Electronic Health Records / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mass Screening / legislation & jurisprudence
  • Mass Screening / methods*
  • Mass Screening / statistics & numerical data
  • Massachusetts
  • Medicaid
  • Pediatrics / legislation & jurisprudence
  • Pediatrics / methods*
  • Pediatrics / statistics & numerical data
  • Primary Health Care / legislation & jurisprudence
  • Primary Health Care / methods*
  • Primary Health Care / statistics & numerical data
  • Program Evaluation / methods*
  • Program Evaluation / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data
  • United States
  • Urban Population
  • Young Adult