Assessing early implementation of state autism insurance mandates.
Julia Berlin Baller, Colleen L Barry, Kathleen Shea and 3 others
PMID 26614401WHAT IT FOUND
Stakeholders in five states said autism insurance mandates raised expectations and service use, shifted payment to private insurers in four states, but provider supply, credentialing, and co-pays still limited access.
Key findings
01Participants from all five states said mandates increased families’ expectations and subsequent service use.
02In four of five states, participants said mandates shifted payment for autism services to commercial insurers.
03Participants from all five states said there was not enough service capacity to meet demand.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study included only five states, so it may not reflect other states. Researchers were not always able to reach providers and insurers in every state, so representation was incomplete. The findings come from 17 interviews and may not represent all advocacy groups, providers, or insurers. Participants described events from 2009 to 2014, so recall may be inaccurate. Qualitative interviews could not measure actual service use or spending changes. The team used one coder and did not calculate inter-rater reliability.
The easy way to misread this
Do not read this as proof that autism mandates improved clinical care or access for all families. It reports stakeholder perceptions from 17 interviews in five states, and a sizable share of employees are in self-insured plans exempt from state mandates.