Original Article
Physical and Behavioral Health of Medicaid Children in Two Southern States
Abstract
Objectives: As the primary insurer of children in the United States, Medicaid covers at least one in four US children. Information on the health and behavioral health needs of this group of children is critical to plan, deliver, and monitor services accordingly.
Methods: Parent interview data from a representative sample of Medicaid children in two Southern states were used to generate information from standardized questionnaires on physical health status, chronic illnesses, physical functioning, emotional and behavioral symptoms, and psychosocial functioning.
Results: The levels of physical and behavioral health and co-occurring problems were higher than other estimates available on the general population.
Conclusions: The high levels of health problems among Medicaid-enrolled children need attention in the current struggles over Medicaid reform. Support for improving screening, referral, and integration of services is discussed, as well as the importance of monitoring service system performance in this era of managed care.
Key Points
* Medicaid children have high levels of physical and behavioral health problems that need identification and treatment.
* Approximately one of every three Medicaid children reported a chronic health condition, with one of every four having some type of physical limitation as a result.
* One quarter of the Medicaid children had emotional or behavioral health problems at levels severe enough to be classified as having a serious emotional disorder.
* Many children had co-occurring physical and behavioral health problems, with children with serious emotional disorders more likely to have physical health problems than those with less severe behavioral problems.
* To promote physical and behavioral health, early identification, treatment, and coordination are critical—between physicians and mental health professionals as well as at the policy level.
* State Medicaid agencies should monitor access to physical and behavioral health services and managed care contractor compliance with performance indicators.
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