The Association of the Medicaid 1915(c) Home and Community-Based Services Waivers with Emergency Department Utilization Among Youth with Autism Spectrum Disorder
Published in: Journal of Autism and Developmental Disorders, Volume 52, pages 1587–1597 (April 2022). doi: 10.1007/s10803-021-05060-2
Posted on RAND.org on November 13, 2023
Using the 2008-2013 Medicaid Analytic eXtract files, this retrospective cohort study was to evaluate the effect of Medicaid home and community-based services (HCBS) waiver programs on emergency department (ED) utilizations among youth with autism spectrum disorder (ASD). Our study showed that the annual ED utilization rates were 13.5% and 18.8% for individuals on autism specific and intellectual and developmental disabilities (IDD) waivers respectively, vs. 28.5% for those without a waiver. Multivariable logistic regression showed that, compared to no waiver, autism specific waivers (adjusted odds ratio: 0.62; 95% Confidence Interval: [0.58–0.66]) and IDD waivers (0.65; [0.64–0.66]) were strongly associated with reduced ED. These findings suggest that HCBS waivers are effective in reducing the incidence of ED visits among youth with ASD.