The Effects of Medicaid Home and Community-based Services Waivers on Unmet Needs Among Children With Autism Spectrum Disorder

Bibliographic Data

ID9101578
AuthorsDouglas L Leslie (Penn State College of Medicine), Douglas Leslie (0000-0001-6145-4610, Penn State Milton S. Hershey Medical Center, corresponding author), Khaled Iskandarani (Penn State College of Medicine, corresponding author), Andrew W Dick (RAND Corporation, Pittsburgh), David S Mandell (0000-0001-8240-820X, University of Pennsylvania), Hao Yu (0009-0004-5499-5565, RAND Corporation, Pittsburgh), Diana Velott (Penn State College of Medicine), Diana L Velott (0000-0001-5236-6723, Penn State Milton S. Hershey Medical Center, corresponding author), Edeanya Agbese (Penn State College of Medicine, corresponding author), Bradley D Stein (0000-0003-1544-458X, RAND Corporation, Pittsburgh)
Year2017
Volume55
Issue1
Pages57-63
Publication date2017-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000621
PMID27547947
OpenAlexW2507403292
LanguageEN
Citations received4
References cited21

BACKGROUND: Several states have passed Medicaid Home and Community-based Services (HCBS) waivers that expand eligibility criteria and available services for children with autism spectrum disorder (ASD). Previous research has shown considerable variation in these waivers, but little is known about the extent to which they address the health care needs of children with ASD. OBJECTIVE: To determine the effects of Medicaid HCBS waivers, and their characteristics, on unmet health care needs among children with ASD. METHODS: We used data from the 2003, 2007, and 2011 waves of the National Survey of Children's Health with detailed information on the Medicaid HCBS waiver programs of 35 states. Quasi-difference-in-difference-in-differences models were used to determine the effects of waivers and their characteristics on parent report of unmet health care needs of children with ASD compared with children without ASD. RESULTS: Greater waiver cost limits per child, estimated costs of services, and enrollment limits were associated with significant decreases in the adjusted rate of unmet health care needs, with considerable variation by household income level. CONCLUSIONS: These findings suggest that Medicaid HCBS waivers significantly decrease the unmet need for health care among children with ASD, most substantially among those who would not otherwise qualify for Medicaid. The findings regarding the effects of specific aspects of these waivers can inform the development of insurance policies in other states to address the needs of children with ASD

Autism · Autism spectrum disorder · Family medicine · Health care · Medicaid · Political science · Psychiatry · Waiver · Autism Spectrum Disorder Research · Family and Disability Support Research · Healthcare Policy and Management · Medicine · Gerontology

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