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- Title
How does being part of a pediatric accountable care organization impact health service use for children with disabilities?
- Authors
Song, Paula H.; Xu, Wendy Yi; Chisolm, Deena J.; Alexy, Emily R.; Ferrari, Renée M.; Hilligoss, Brian; Domino, Marisa Elena
- Abstract
<bold>Objective: </bold>To examine the impact of a Medicaid-serving pediatric accountable care organization (ACO) on health service use by children who qualify for Medicaid by virtue of a disability under the "aged, blind, and disabled" (ABD) eligibility criteria.<bold>Data Sources/study Setting: </bold>We evaluated a 2013 Ohio policy change that effectively moved ABD Medicaid children into an ACO model of care using Ohio Medicaid administrative claims data for years 2011-2016.<bold>Study Design: </bold>We used a difference-in-difference design to examine changes in patterns of health care service use by ABD-enrolled children before and after enrolling in an ACO compared with ABD-enrolled children enrolled in non-ACO managed care plans.<bold>Data Collection/extraction Methods: </bold>We identified 17 356 children who resided in 34 of 88 counties as the ACO "intervention" group and 47 026 ABD-enrolled children who resided outside of the ACO region as non-ACO controls.<bold>Principal Findings: </bold>Being part of the ACO increased adolescent preventative service and decreased use of ADHD medications as compared to similar children in non-ACO capitated managed care plans. Relative home health service use decreased for children in the ACO.<bold>Conclusions: </bold>Our overall results indicate that being part of an ACO may improve quality in certain areas, such as adolescent well-child visits, though there may be room for improvement in other areas considered important by patients and their families such as home health service.
- Subjects
CHILD health services; ACCOUNTABLE care organizations; SERVICES for children with disabilities; MANAGED care programs; CHILDREN with disabilities; MEDICAL care use; MEDICAID beneficiaries
- Publication
Health Services Research, 2019, Vol 54, Issue 5, p1007
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13199