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Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care

Therapeutic foster care (TFC) is a service for children with high behavioral health needs that has shown promise to prevent entry into more restrictive and expensive care settings. The purpose of this study was to compare Medicaid expenditures associated with TFC with Medicaid expenditures associate...

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Detalles Bibliográficos
Autores principales: Lanier, Paul, Rose, Roderick, Domino, Marisa Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169148/
https://www.ncbi.nlm.nih.gov/pubmed/37160645
http://dx.doi.org/10.1007/s10488-023-01270-1
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author Lanier, Paul
Rose, Roderick
Domino, Marisa Elena
author_facet Lanier, Paul
Rose, Roderick
Domino, Marisa Elena
author_sort Lanier, Paul
collection PubMed
description Therapeutic foster care (TFC) is a service for children with high behavioral health needs that has shown promise to prevent entry into more restrictive and expensive care settings. The purpose of this study was to compare Medicaid expenditures associated with TFC with Medicaid expenditures associated with an enhanced higher-rate service called Intensive Alternative Family Treatment (IAFT). We conducted a secondary analysis of Medicaid claims in North Carolina among children entering care in 2018–2019. Using propensity score analysis with difference-in-difference estimation, we compared monthly Medicaid expenditures before and after initiating TFC and IAFT (N = 5472 person-months). Youth entering IAFT had higher expenditures prior to treatment than those entering TFC. Both standard TFC and IAFT were associated with a downward trend in expenditures following treatment initiation. Both TFC and IAFT reverse a trend of increasing Medicaid costs prior to care among children with high behavioral health needs.
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spelling pubmed-101691482023-05-11 Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care Lanier, Paul Rose, Roderick Domino, Marisa Elena Adm Policy Ment Health Original Article Therapeutic foster care (TFC) is a service for children with high behavioral health needs that has shown promise to prevent entry into more restrictive and expensive care settings. The purpose of this study was to compare Medicaid expenditures associated with TFC with Medicaid expenditures associated with an enhanced higher-rate service called Intensive Alternative Family Treatment (IAFT). We conducted a secondary analysis of Medicaid claims in North Carolina among children entering care in 2018–2019. Using propensity score analysis with difference-in-difference estimation, we compared monthly Medicaid expenditures before and after initiating TFC and IAFT (N = 5472 person-months). Youth entering IAFT had higher expenditures prior to treatment than those entering TFC. Both standard TFC and IAFT were associated with a downward trend in expenditures following treatment initiation. Both TFC and IAFT reverse a trend of increasing Medicaid costs prior to care among children with high behavioral health needs. Springer US 2023-05-09 /pmc/articles/PMC10169148/ /pubmed/37160645 http://dx.doi.org/10.1007/s10488-023-01270-1 Text en © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Lanier, Paul
Rose, Roderick
Domino, Marisa Elena
Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care
title Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care
title_full Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care
title_fullStr Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care
title_full_unstemmed Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care
title_short Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care
title_sort comparing medicaid expenditures for standard and enhanced therapeutic foster care
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169148/
https://www.ncbi.nlm.nih.gov/pubmed/37160645
http://dx.doi.org/10.1007/s10488-023-01270-1
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