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Eye Tracking Young Children with Autism
Published on: March 27, 2012
Spending on Young Children With Autism Spectrum Disorder in Employer-Sponsored Plans, 2011-2017
Scott D Grosse1, Xu Ji1, Phyllis Nichols1
1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta (Grosse, Nichols, Yeargin-Allsopp); Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta (Ji); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Rice). This work was performed when Dr. Ji was a Prevention Effectiveness Fellow at the CDC.
Insights
Healthcare spending for privately insured children with autism spectrum disorder (ASD) increased significantly from 2011 to 2017, driven by behavioral interventions. This rise outpaced spending for children without ASD, impacting overall healthcare costs.
Area of Science:
- Pediatric Health Economics
- Autism Spectrum Disorder (ASD) Research
- Healthcare Services Utilization
Background:
- Rising autism spectrum disorder (ASD) prevalence and increased access to intensive behavioral interventions likely contribute to escalating healthcare expenditures.
- Understanding recent trends in healthcare spending for children with ASD is crucial for resource allocation and policy development.
Purpose of the Study:
- To estimate changes in healthcare spending among privately insured children with and without current autism spectrum disorder (ASD) diagnoses between 2011 and 2017.
- To analyze the impact of behavioral interventions on overall healthcare costs for children with ASD.
Main Methods:
- Analysis of repeated cross-sections of 2011-2017 claims data from large employer-sponsored health plans.
- Assessment of annual expenditures by service type for children aged 3-7 with and without ASD diagnoses.
Main Results:
- Mean annual spending per child with ASD increased by 51% (from ~$13,000 to ~$20,000) between 2011 and 2017.
- Outpatient behavioral intervention spending for children with ASD surged by 376% ($1,746 to $8,317), accounting for a larger share of total spending.
- Spending for children with ASD grew six times more than for children without ASD, contributing significantly to overall healthcare spending growth.
Conclusions:
- Healthcare spending for privately insured children with ASD increased substantially from 2011-2017, primarily due to behavioral intervention costs.
- By 2017, one in seven children with ASD received at least $20,000 in services, highlighting the significant financial impact.
- The findings underscore the growing economic burden associated with ASD care and the critical role of behavioral interventions.
Objective:
Rapid increases in the prevalence of autism spectrum disorder (ASD) and increased access to intensive behavioral interventions have likely increased health care spending. This study estimated recent changes in spending among privately insured children with and without current ASD.
Methods:
A repeated cross-sections analysis of 2011-2017 claims data from large-employer-sponsored health plans assessed changes in annual expenditures by service type for children ages 3-7 enrolled for ≥1 year and with two or more claims with ASD billing codes within a calendar year and for all other children.
Results:
Mean spending per child with a current-year ASD diagnosis increased by 51% in 2017 U.S. dollars, from roughly $13,000 in 2011 to $20,000 in 2017. Among children who did not meet the current-year ASD case definition, per-child spending increased by 8%. Spending on children with ASD accounted for 41% of spending growth for children ages 3-7 during 2011-2017. Outpatient behavioral intervention-related spending per child with ASD increased by 376%, from $1,746 in 2011 to $8,317 in 2017; spending on all other services increased by 2%. Their share of behavioral intervention-related spending increased from 13.2% in 2011 to 41.7% in 2017. In 2011, 2.5% of children with current-year ASD diagnoses incurred ≥$20,000 in outpatient behavioral intervention-related spending, which increased to 14.4% in 2017.
Conclusions:
During 2011-2017, spending increased six times as much for privately insured children ages 3-7 with current-year ASD as for children without ASD, largely from increased behavioral intervention-related spending. One in seven children received at least $20,000 in services in 2017.
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