Related Experiment Video
Updated: Apr 23, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Behavioral health services following implementation of screening in Massachusetts Medicaid children
Karen A Hacker1, Robert B Penfold2, Lisa N Arsenault3
1Allegheny County Health Department, and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; khacker@ACHD.net.
Insights
Massachusetts Medicaid children screened for behavioral health (BH) needs showed increased recognition, but only one-third of newly identified children received services. Further strategies are needed to improve BH service engagement.
Area of Science:
- Child health services research
- Public health policy
- Behavioral health integration
Background:
- Mandatory behavioral health (BH) screening in Massachusetts primary care settings aimed to improve service access for children.
- Understanding the link between screening and actual service utilization is crucial for evaluating program effectiveness.
Purpose of the Study:
- To examine the relationship between child behavioral health (BH) screening results and subsequent receipt of BH services among Massachusetts Medicaid (MassHealth) enrollees.
- To identify predictors of postscreening BH service utilization.
Main Methods:
- Analysis of MassHealth claims data for continuously enrolled children from July 2007 to June 2010.
- Utilized screening codes and modifiers to identify BH needs and track postscreening services.
- Employed logistic regression to determine factors associated with receiving BH services.
Main Results:
- Of 261,160 children, 45% underwent BH screening; 37% had a positive modifier indicating a BH need.
- Children screening positive were more likely to receive services (57%) than those screening negative (22%).
- Only 30% of newly identified children received BH services; foster care status and positive screening modifiers predicted service receipt.
Conclusions:
- BH screening increases recognition of child BH needs.
- Screening alone is insufficient to guarantee access to necessary BH services for all identified children.
- Enhanced strategies are required to improve engagement and ensure timely delivery of BH care to children.
Objectives:
To determine the relationship of child behavioral health (BH) screening results to receipt of BH services in Massachusetts Medicaid (MassHealth) children.
Methods:
After a court decision, Massachusetts primary care providers were mandated to conduct BH screening at well-child visits and use a Current Procedural Terminology code along with a modifier indicating whether a BH need was identified. Using MassHealth claims data, a cohort of continuously enrolled (July 2007-June 2010) children was constructed. The salient visit (first use of the modifier, screening code, or claim in fiscal year 2009) was considered a reference point to examine BH history and postscreening BH services. Bivariate and multivariate logistic regression analyses were performed to determine predictors of postscreening BH services.
Results:
Of 261,160 children in the cohort, 45% (118,464) were screened and 37% had modifiers. Fifty-seven percent of children screening positive received postscreening BH services compared with 22% of children screening negative. However, only 30% of newly identified children received BH services. The strongest predictors of postscreening BH services for children without a BH history were being in foster care (odds ratio, 10.38; 95% confidence interval, 9.22-11.68) and having a positive modifier (odds ratio, 3.79; 95% confidence interval, 3.53-4.06).
Conclusions:
Previous BH history, a positive modifier, and foster care predicted postscreening BH services. Only one-third of newly identified children received services. Thus although screening is associated with an increase in BH recognition, it may be insufficient to improve care. Additional strategies may be needed to enhance engagement in BH services.
More Related Videos
11:39Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
10:22Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016