ADHD Treatment - New Report Identifies Problems With Medicaid ADHD Treatment

An article in the December issue of the Journal of the American Academy of Child and Adolescent Psychiatry titled “Quality of Care for Childhood Attention - Deficit/ Hyperactivity Disorder in a Managed Care Medicaid Program” calls into question the caliber of care being provided within the nation’s Medicaid program.

The article reports on primary care that was provided to 530 ADHD-affected children between the ages of 5 to 11 from November 2004 through to September 2006. The analysis came from data reported through parent and child interviews, school records and pharmacy charges. The study was broken up into three 6-month time frames.

Dr. Bonnie Zima and fellow researchers found that quality care was inconsistent across the board for children with ADHD. Children obtaining treatment in primary care programs were generally prescribed stimulant medication and only followed up two times per year, as opposed to children in specialty care who averaged about 5 mental health follow-ups per month. Among both groups, in excess of 33% completely quit all care, refills for medication were inconsistent, and surprisingly, successful clinical results were no different for children who stayed with care as those who did not.

In the article, the researchers said, “Findings from this study identify several areas for quality improvement for ADHD care within the managed care Medicaid program studied. These areas are alignment of the child’s clinical severity with provider type, frequency of follow-up visits, stimulant medication use in specialty mental health, agency data infrastructure to document delivery of evidence-based psychosocial treatments, and stimulant medication refill prescription persistence. The enduring symptoms, impairment, and poor academic achievement of the children who remain in care and those untreated underscores the public health significance of improving the quality of care for publicly insured children with ADHD.”

The reason for the study of children with ADHD in the care of Medicaid is the fact that ADHD is one of the commonest mental health conditions touching 3%- 10% of American children. Furthermore, over one third of federal healthcare spending is covered by Medicaid.

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