Identifying Under- and Overutilization Patterns for Idaho Youth with Serious Emotional Disturbance

In 2017, the state of Idaho launched the Youth Empowerment Service (YES) program, targeting children and adolescents with serious emotional disturbance (SED). This initiative allows the youth, particularly those under eighteen and from households earning up to 300% of the federal poverty level, to qualify for Medicaid and access comprehensive, community-based treatments.

Utilizing the Child and Adolescent Needs and Strengths (CANS) tool—a 97-indicator assessment administered by clinicians—researchers analyzed Medicaid claims data from 2018 to 2022 to understand service utilization patterns.?According to the study by @Olga A. Vsevolozhskaya, Madison Merzke, Wiley T. Turner, Xiaoran Tong, Seth Himelhoch, and John S. Lyons, of University of Kentucky , published in the August issue of Health Affairs, findings revealed a significant underuse of Medicaid behavioral and mental health services among this population, highlighting the necessity for tailored utilization management to ensure appropriate care access and retention within the YES program.

Children with Serious Emotional Disturbances face significant challenges that necessitate comprehensive and coordinated mental health services. While Medicaid and the Affordable Care Act have expanded access to these essential services, ensuring appropriate utilization remains a challenge. By addressing the factors contributing to underutilization and implementing targeted strategies for outreach, engagement, and tailored care, we can better support these vulnerable youth. Ultimately, the goal is to provide the necessary support for children with SED to thrive in their homes and communities, leading to better outcomes and brighter futures.

Read more: https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2023.01256