Key Issues in the First Year of Transition for a Large Medicaid-Funded Children's Service.

Abstract

Behavioral Health Rehabilitation Service (BHRS) is a comprehensive service for Pennsylvania's Medicaid-enrolled youth and their families. In 2021, BHRS transitioned to Intensive Behavioral Health Service (IBHS) through state-wide policy change. To assess impact, the largest behavioral health managed care organization in the state compared service utilization in BHRS in 2019 versus IBHS in 2021. Results show that significantly more youth received non-Applied Behavior Analysis (non-ABA) services in BHRS (n = 13,795) than IBHS (n = 10,083) and more youth were discharged during the measurement period for BHRS versus IBHS (47% vs. 44%). Significantly more youth received ABA through IBHS versus BHRS (n = 4,385 vs. n = 2,690). The number of youth served in therapeutic service in IBHS did not indicate improved access during this first year of transition; however, more youth received evidence based treatments through IBHS indicating higher quality care for some youth and families.