Date of Award
Master of Public Health (MPH)
Shanta Dube, PhD, MPH
William Thompson, PhD
BACKGROUND: It is recognized among providers, parents and health organizations that the current health care system is unprepared for a rising number of children diagnosed with Autism Spectrum Disorder (ASD) worldwide. Meanwhile, differences in mandated insurance coverage for ASD across the U.S. could drastically impact the diagnosis and treatment strategies chosen by providers and families. PURPOSE OF RESEARCH: The present case study aimed to review and compare policies and programs for children and adolescents with ASD in Pennsylvania (PA) and Georgia (GA), focusing on private insurance mandates. Additionally, the case study intended to identify and evaluate data sources that can be used to assess the implementation and impact of ASD insurance mandates in those states. METHODS: Key advocates and health agencies’ representatives were contacted to collaborate in the identification of the state regulated initiatives and potential data sources that track children and adolescents with ASD. Insurance enrollment, pharmacy care, health care service utilization, and cost of care were the indicators used to evaluate data sources in their ability to evaluate the impact of the insurance mandates. RESULTS: PA showed a more comprehensive insurance mandate and state-driven health-related initiatives for children and adolescents with ASD than GA. Among the nine data sources reviewed, including claims and survey data, none provide essential indicators for a comprehensive evaluation of the impact of the ASD insurance mandate in PA or GA. CONCLUSION: The case study indicated that for GA and PA, ASD policy tracking and evaluation can be accomplished with some of the currently available data sources, however, important gaps in the surveillance of ASD-related outcomes exist. Thus, the study suggested that efforts towards more comprehensive data sources across all states is needed in order to evaluate ASD initiatives that inform ASD related- health policy and programs.
Campos Vidal Pires, Sofia, "Insurance Mandates for Diagnosis and Treatment of Children and Adolescents with Autism and Evaluative Data Sources: A Case Study of Two U.S. States." , Georgia State University, 2015.