TY - JOUR
T1 - Identifying Under-And Overutilization Patterns For Idaho Youth With Serious Emotional Disturbance
AU - Vsevolozhskaya, Olga A.
AU - Merzke, Madison
AU - Turner, Wiley T.
AU - Tong, Xiaoran
AU - Himelhoch, Seth
AU - Lyons, John S.
N1 - Publisher Copyright:
© 2024, Project HOPE. All rights reserved.
PY - 2024/8
Y1 - 2024/8
N2 - Children and adolescents with serious emotional disturbance represent 7–12 percent of all youth in the United States. In 2017, the State of Idaho implemented the Youth Empowerment Service program, which allows youth with serious emotional disturbance who are younger than age eighteen living in households with income up to 300 percent of the federal poverty level to qualify for Medicaid and receive intensive, community-based treatment. A uniquely detailed method was used to assess the need for services: the Child and Adolescent Needs and Strengths tool, a ninety-seven-indicator instrument administered by a clinician. We used these indicators and Idaho’s 2018–22 administrative Medicaid claims data to study the association between children and adolescents’ clinical needs complexity and their actual Medicaid behavioral and mental health service use. Our findings show that there was a substantial proportion of youth who were underusing Medicaid behavioral and mental health care services, and there were virtually no overusers. Our findings have implications for the appropriateness of Medicaid utilization management in behavioral health care and program efforts to maintain families with youth having serious emotional disturbance in the Youth Empowerment Service program.
AB - Children and adolescents with serious emotional disturbance represent 7–12 percent of all youth in the United States. In 2017, the State of Idaho implemented the Youth Empowerment Service program, which allows youth with serious emotional disturbance who are younger than age eighteen living in households with income up to 300 percent of the federal poverty level to qualify for Medicaid and receive intensive, community-based treatment. A uniquely detailed method was used to assess the need for services: the Child and Adolescent Needs and Strengths tool, a ninety-seven-indicator instrument administered by a clinician. We used these indicators and Idaho’s 2018–22 administrative Medicaid claims data to study the association between children and adolescents’ clinical needs complexity and their actual Medicaid behavioral and mental health service use. Our findings show that there was a substantial proportion of youth who were underusing Medicaid behavioral and mental health care services, and there were virtually no overusers. Our findings have implications for the appropriateness of Medicaid utilization management in behavioral health care and program efforts to maintain families with youth having serious emotional disturbance in the Youth Empowerment Service program.
UR - http://www.scopus.com/inward/record.url?scp=85203089885&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85203089885&partnerID=8YFLogxK
U2 - 10.1377/HLTHAFF.2023.01256
DO - 10.1377/HLTHAFF.2023.01256
M3 - Article
AN - SCOPUS:85203089885
SN - 0278-2715
VL - 43
SP - 1109
EP - 1116
JO - Health Affairs
JF - Health Affairs
IS - 8
ER -