Inequities in Receipt of the North Carolina Medicaid Waiver Among Individuals with Intellectual Disability or Autism Spectrum Disorder.
Michelle S Franklin, Christopher Bush, Kelley A Jones and 5 others
PMID 35353786WHAT IT FOUND
Children and racial minorities were significantly less likely to receive North Carolina's Medicaid I/DD Waiver than adults and White patients.
Waiver recipients had 31% lower odds of emergency department visits. These disparities suggest current access systems fail vulnerable groups.
Key findings
01Children aged 0-17 were 61% less likely to receive the NC I/DD Waiver compared with adults older than 21.
02Hispanic White and non-Hispanic Black patients were 37% and 15% less likely to receive the Waiver compared with non-Hispanic White patients.
03Individuals who received the NC I/DD Waiver were 31% less likely to use the emergency department compared with those without the benefit.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The findings are specific to North Carolina Medicaid patients and may not generalize to other states or insurance types. The study only looked at a 12-month period and did not require continuous enrollment, which could affect estimates of service receipt. Patients were classified as having an I/DD if they had at least one claim with a qualifying diagnosis code, which may include some misclassification. The study describes associations but cannot prove that receiving the Waiver caused the reduction in emergency department visits.
Declared interests
The research was supported by the Arc of North Carolina and the North Carolina Department of Health and Human Services. One author disclosed personal fees from Roche.
The easy way to misread this
Do not assume that receiving the I/DD Waiver directly causes the reduction in emergency department visits. The study shows an association, but it cannot rule out that healthier or better-supported individuals are both more likely to get the Waiver and less likely to visit the ED.