Journal of Autism and Developmental Disorders

, Volume 43, Issue 5, pp 1057–1064

Healthcare Service Use and Costs for Autism Spectrum Disorder: A Comparison Between Medicaid and Private Insurance

Authors

    • Department of Public Health Sciences, College of MedicinePennsylvania State University
    • Penn State College of Medicine Public Health Sciences
  • David S. Mandell
    • Department of Psychiatry and Pediatrics, School of MedicineUniversity of Pennsylvania
  • Lindsay Lawer
    • Department of Psychiatry, Center for Mental Health Policy and Services Research, School of MedicineUniversity of Pennsylvania
  • Zuleyha Cidav
    • Department of Psychiatry, Center for Mental Health Policy and Services Research, School of MedicineUniversity of Pennsylvania
  • Douglas L. Leslie
    • Department of Public Health Sciences, College of MedicinePennsylvania State University
    • Department of Psychiatry, College of MedicinePennsylvania State University
Original Paper

DOI: 10.1007/s10803-012-1649-y

Cite this article as:
Wang, L., Mandell, D.S., Lawer, L. et al. J Autism Dev Disord (2013) 43: 1057. doi:10.1007/s10803-012-1649-y

Abstract

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 ($22,653 vs. $5,254), higher ASD-specific costs ($7,438 vs. $928), higher psychotropic medication costs($1,468 vs. $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.

Keywords

Autism spectrum disorderChildrenHealthcare costsService useMedicaidPrivate insurance

Copyright information

© Springer Science+Business Media, LLC 2012