Skip to main content

Advertisement

Log in

Autism Prevalence in the Medicaid Program and Healthcare Utilization and Costs Among Adult Enrollees Diagnosed with Autism

  • Original Article
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

As the number of individuals diagnosed with autism increases, there is an increase in demand to provide support throughout their lifespan. This study aimed to: (1) estimate trends in the prevalence of autism diagnoses and medical services use in adults with autism diagnoses; (2) assess predictors of healthcare utilization and costs among adults with autism diagnoses enrolled in Medicaid. A retrospective analysis of 2006–2008 Medicaid claims for 39 states was conducted. There was a 38% increase in the prevalence of autism diagnoses from 2006 to 2008. Total expenditures and outpatient and ER visits varied significantly by demographic variables.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association. (2013). Diagnostic criteria for 299.00 Autistic Disorder. Diagnostic and Statistical Manual of Mental Disorders (5th ed ed.). Washington DC: American Psychiatric Association.

    Book  Google Scholar 

  • Boyle, C. A., Boulet, S., Schieve, L. A., Cohen, R. A., Blumberg, S. J., Yeargin-Allsopp, M., et al. (2011). Trends in the prevalence of developmental disabilities in US children, 1997–2008. Pediatrics, 127, 1034–1042.

    Article  Google Scholar 

  • Brugha, T. S., McManus, S., Bankart, J., Scott, F., Purdon, S., Smith, J., et al. (2011). Epidemiology of autism spectrum disorders in adults in the community in England. Archives of General Psychiatry, 68, 459–465.

    Article  Google Scholar 

  • Buck, T. R., Viskochil, J., Farley, M., Coon, H., McMahon, W. M., Morgan, J., et al. (2014). Psychiatric comorbidity and medication use in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44, 3063–3071.

    Article  Google Scholar 

  • Buescher, A. V. S., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics, 168(8), 721.

    Article  Google Scholar 

  • Cidav, Z., Lawer, L., Marcus, S. C., & Mandell, D. S. (2012). Age-related variation in health service use and associated expenditures among children with autism. Journal of Autism and Developmental Disorders, 43, 924–931.

    Article  Google Scholar 

  • Cimera, R. E., & Cowan, R. J. (2009). The costs of services and employment outcomes achieved by adults with autism in the US. Autism, 13, 285–302.

    Article  Google Scholar 

  • Croen, L. A., Najjar, D. V., Ray, G. T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118, e1203–e1211.

    Article  Google Scholar 

  • Deyo, R. A., Cherkin, D. C., & Ciol, M. A. (1992). Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology, 45, 613–619.

    Article  CAS  Google Scholar 

  • Fortuna, R. J., Robins, L., Smith, T. H., Meccarello, J., Bullen, B., Nobis, K., et al. (2015). Health conditions and functional status in adults with autism: A cross-sectional evaluation. Journal of General Internal Medicine, 31(1), 77–84.

    Article  Google Scholar 

  • Iannuzzi, D. A., Cheng, E. R., Broder-Fingert, S., & Bauman, M. L. (2014). Brief report: Emergency department utilization by individuals with autism. Journal of Autism and Developmental Disorders, 45, 1096–1102.

    Article  Google Scholar 

  • Kohane, I. S., McMurry, A., Weber, G., MacFadden, D., Rappaport, L., Kunkel, L., et al. (2012). The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS ONE, 7(4), e33224–e33224.

    Article  CAS  Google Scholar 

  • Liptak, G. S., Stuart, T., & Auinger, P. (2006). Health care utilization and expenditures for children with autism: Data from U.S. national samples. Journal of Autism and Developmental Disorders, 36(7), 871–879.

    Article  Google Scholar 

  • Magana, S., Parish, S. L., Rose, R. A., Timberlake, M., & Swaine, J. G. (2012). Racial and ethnic disparities in quality of health care among children with autism and other developmental disabilities. Journal of Intellectual and Developmental Disability, 50, 287–299.

    Article  Google Scholar 

  • Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1447–1453.

    Article  Google Scholar 

  • Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., DiGuiseppi, C., Durkin, M. S., et al. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99, 493–498.

    Article  Google Scholar 

  • Nicolaidis, C., Raymaker, D., McDonald, K., Dern, S., Boisclair, W. C., Ashkenazy, E., et al. (2012). Comparison of healthcare experiences in autistic and non-autistic adults: A cross-sectional online survey facilitated by an academic-community partnership. Journal of General Internal Medicine, 28, 761–769.

    Article  Google Scholar 

  • RUCA Data. (2013). Rural-urban commuting area codes (RUCAs). Retrieved June 9th, 2015, from www. http://depts.washington.edu/uwruca/.

  • Shimabukuro, T. T., Grosse, S. D., & Rice, C. (2008). Medical expenditures for children with an autism spectrum disorder in a privately insured population. Journal of Autism and Developmental Disorders, 38(3), 546–552.

    Article  Google Scholar 

  • Wingate, M., Kirby, R. S., Pettygrove, S., Cunniff, C., Schulz, E., Ghosh, T., et al. (2014). Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveillance Summaries, 63, 1–21.

    Google Scholar 

Download references

Funding

This study was part of a larger project funded by the Organization for Autism Research and a University of Mississippi Graduate School Council Research Grant. The study was presented as a poster at the 2014 Annual Research Meeting (ARM), AcademyHealth, June 8–10, San Diego, CA.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Krutika Jariwala-Parikh.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jariwala-Parikh, K., Barnard, M., Holmes, E.R. et al. Autism Prevalence in the Medicaid Program and Healthcare Utilization and Costs Among Adult Enrollees Diagnosed with Autism. Adm Policy Ment Health 46, 768–776 (2019). https://doi.org/10.1007/s10488-019-00960-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-019-00960-z

Keywords

Navigation