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Effects of State Autism Mandate Age Caps on Health Service Use and Spending Among Adolescents.
- Source :
-
Journal of the American Academy of Child and Adolescent Psychiatry [J Am Acad Child Adolesc Psychiatry] 2018 Feb; Vol. 57 (2), pp. 125-131. Date of Electronic Publication: 2017 Dec 05. - Publication Year :
- 2018
-
Abstract
- Objective: Many states with mandates requiring commercial insurers to cover autism spectrum disorder (ASD) health services specify upper age limits above which coverage is no longer mandated. It is unknown what effects these age caps have on health service use and spending among adolescents who have exceeded the age cap.<br />Method: Using administrative claims data from 3 national commercial insurers, a difference-in-differences approach was used to estimate effects of age caps on health service use and spending among adolescents with ASD. Statistical models compared changes in use and spending between those above versus below the age cap among individuals eligible versus ineligible for mandated coverage. The analytic sample included data from 2008 through 2012 on 7,845 individuals (151,976 person-months) ages 10 to 21 years in 11 states imposing mandate age caps going into effect during adolescence.<br />Results: Age caps were associated with 4.2 percentage point (95% CI = -7.0, -1.5) lower probability of any ASD-specific service use in a month and $69 less (95% CI = -112, -$26) in average monthly spending on ASD-specific services than would have been expected given concomitant pre-post age cap differences among individuals in the same states who were never eligible for mandate-covered services. In addition, age caps were associated with $99 (95% CI = -$168, -$30) lower average monthly spending on all health care services.<br />Conclusion: Insurance mandates that include age caps going into effect during adolescence reduce health service use and spending among individuals with ASD during a critical phase of the life course.<br /> (Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Age Factors
Autism Spectrum Disorder economics
Child
Female
Humans
Insurance Claim Review statistics & numerical data
Male
Patient Acceptance of Health Care statistics & numerical data
United States
Young Adult
Autism Spectrum Disorder therapy
Insurance Coverage economics
Insurance Coverage legislation & jurisprudence
Insurance, Health economics
Insurance, Health legislation & jurisprudence
Subjects
Details
- Language :
- English
- ISSN :
- 1527-5418
- Volume :
- 57
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Child and Adolescent Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 29413145
- Full Text :
- https://doi.org/10.1016/j.jaac.2017.10.019