Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence.
Meghan E Carey, Katherine Ardeleanu, Steven C Marcus and 4 others
PMID 37272053WHAT IT FOUND
Autistic Medicaid beneficiaries with coverage gaps were more likely to accrue an intellectual disability diagnosis than those without gaps.
This often occurred during the transition to adulthood, suggesting new diagnoses may serve as a mechanism to retain insurance access rather than reflect clinical need.
Key findings
01Approximately one in five autistic young people accrued an intellectual disability diagnosis between ages 8 and 25.
02Individuals with disruptions in Medicaid coverage had a higher probability of accruing an intellectual disability diagnosis compared with those without disruptions.
03The probability of accruing an intellectual disability diagnosis peaked at ages 19 and 21, coinciding with transitions to adult Medicaid eligibility and termination of school supports.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used administrative claims data, which were not collected for research purposes, so the accuracy of diagnoses relies on billing codes rather than clinical criteria. The researchers could not determine the specific reasons for coverage gaps, such as whether individuals gained other insurance. The data ended in 2016, so the findings may not reflect current Medicaid policies or practices.
Declared interests
The study was supported by the National Institutes of Health, and the authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a new intellectual disability diagnosis in an autistic young adult necessarily indicates a decline in cognitive ability or a change in clinical presentation. The study suggests these diagnoses often appear when insurance coverage is disrupted, implying they may be used to retain access to services rather than to describe the patient's actual needs.