OM: BH Costs Account for 38% of Medicaid Costs for Kids

Behavioral Health Costs Account For 38% Of Medicaid Expenditures For Children

Open Minds  December 30, 2013

 

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Behavioral health costs accounted for 38% of Medicaid expenditures for children in 2005, but less than 10% of children in Medicaid used behavioral health services that year. That year 2.8 million children enrolled in Medicaid used some type of behavioral health services; total Medicaid expenditures for these services are estimated at $19.3 billion. Among 2.8 million children in Medicaid using behavioral health care, two-thirds were in the Temporary Aid to Needy Families (TANF) program, and one-third were children in foster care or receiving Supplemental Security Income (SSI) or disability payments. The subgroup of children in foster care and those on SSI/disability accounted for 56% of total behavioral health expenses for children in Medicaid. Behavioral health service use and expenses of children in foster care exceeded that of children on SSI/disability.

 

 Differences among the three populations were reported as follows:

  • Children in TANF represented 92.3% of children in Medicaid, but 67.2% of the 2.8 million using some type of behavioral health care. These children accounted for 44% of spending. The mean annual behavioral expenditure for these children was $3,028.
  • Children in foster care represented 3.2% of children in Medicaid, but 15% of the 2.8 million using some type of behavioral health care. These children accounted for 28.6% of spending. The mean annual behavioral expenditure for these children was $8,094.
  • Children receiving SSI/disability payments represented 4.5% of children in Medicaid, but 17.8% of the 2.8 million using some type of behavioral health care. These children accounted for 27% of spending. The mean annual behavioral expenditure for these children was $7,264.

 

The findings were reported in “Faces of Medicaid: Examining Children's Behavioral Health Service Utilization and Expenditures” by Sheila Pires, MPA; Katherine Grimes, M.D., MPH; Todd Gilmer, Ph.D.; Kamala Allen, MHS; Roopa Mahadevan, MA; and Taylor Hendricks, all of the Center for Health Care Strategies (CHCS). The authors sought to identify behavioral health use and expenditures for children in Medicaid. This report is part of the CHCS series, “Faces of Medicaid.” The current study was funded by the Annie E. Casey Foundation, with support from the Substance Abuse And Mental Health Services Administration, and the Commonwealth Fund. The analysis is based on utilization and expenditure data from the Medicaid Analytic Extract system that includes 29 million children and youth who received Medicaid-financed services in 2005. CHCS is currently pursuing a second phase of this study using 2008 claims data.

 

The 29 million children enrolled in Medicaid represented 38% of the 74.7 million children in the total United States population in 2005. The findings are reported for various age groups, gender, race/ethnicity. The use and costs of psychotropic medication are reported by age, gender, race/ethnicity, and psychiatric diagnosis. Key findings about the 29 million children enrolled in Medicaid in 2005, included the following:

  • About 92.3% of children qualified for Medicaid through the Temporary Aid to Needy Families program; 3.2% were in foster care, and 4.5% were receiving SSI/disability payments.
  • 2.8 million (9.6%) used some type of behavioral health care—Within this group, 39.1% had no behavioral health diagnosis
  • 1.9 million (6.7%) used behavioral health services, with or without psychotropic medications
  • 1.7 million (5.8%) used psychotropic medications with or without behavioral health services
  • 1.1 million (3.8%) used only behavioral health services
  • 0.5 million (1.7%) used only psychotropic medications

 

The 9.6% of children using behavioral health care had estimated costs of $19.3 billion. Their overall mean Medicaid expenditure for physical and behavioral health care was $8,520 annually (or $23.8 million). The annual mean behavioral health expenditure was $4,868; the annual mean physical health expenditure was $3,652.

 

The Center for Health Care Strategies released “Faces of Medicaid: Examining Children's Behavioral Health Service Utilization and Expenditures” in December 2013. A copy can be downloaded atwww.chcs.org/publications3960/publications_show.htm?doc_id=1261588#.Uq2f242A14- (accessed December 26, 2013).

 

For more information, contact: Nancy Archibald, M.B.A., M.H.A., Communications Officer, Center for Health Care Strategies, Inc., 200 American Metro Boulevard, Suite 119, Hamilton, New Jersey 08619; 609-528-8400; Fax: 609-586-3679; E-mail: narchibald@chcs.org; Website: www.chcs.org