Autism spectrum disorder (ASD) is a neurological developmental disorder that affected approximately 1 in 110 children in the United States in 2006, and its prevalence has risen rapidly in recent years. In view of increasingly unmet needs for autism care, more and more states have passed mandates requiring private insurers to provide autism insurance. However, little is known about actual changes in autism services use, costs and health benefits after such mandates take effect. More importantly, access barriers to autism care persist for privately insured autistic children despite autism mandates. Without timely study and informed policy measures to address persistent access barriers, the care of children with ASD may be jeopardized. Using a unique large multi-state private insurance claims database, this research will be: 1) the first study to use post- mandate private insurance claims data to measure actual changes in autism service use, costs and health benefits after autism insurance mandates;and 2) the first study to explore access barriers that persist despite autism mandates. The findings will: 1) help evaluate autism mandates based on actual changes rather than prospective projections;and 2) help decision makers design future autism mandates and identify the next essential steps following the passage of autism insurance mandates to further remove access barriers and better serve children with ASD.

Public Health Relevance

Access barriers to treatment care of Autism Spectrum Disorders (ASD) persist despite autism insurance mandates in more and more states that require private insurers to provide autism care coverage. Using a large, unique multi-state private insurance claims database, this research will be 1) the first study to use nation-wide post-mandate private insurance claims data to measure actual (rather than projected) changes in autism services use, costs and health benefits after the mandate;and 2) the first study to explore access barriers that persist despite autism insurance mandates. Findings from this study will 1) help evaluate autism mandates and design future autism mandates, and 2) help decision makers identify the next essential steps following insurance mandate enactment to further remove access barriers and better serve children with ASD.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH096711-02
Application #
8544496
Study Section
Special Emphasis Panel (SERV)
Program Officer
Rupp, Agnes
Project Start
2012-09-12
Project End
2015-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
2
Fiscal Year
2013
Total Cost
$273,622
Indirect Cost
$70,893
Name
Pennsylvania State University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
129348186
City
Hershey
State
PA
Country
United States
Zip Code
17033
Shiyko, Mariya; Naab, Pamela; Shiffman, Saul et al. (2014) Modeling complexity of EMA data: time-varying lagged effects of negative affect on smoking urges for subgroups of nicotine addiction. Nicotine Tob Res 16 Suppl 2:S144-50