1. Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures,
REPORT CHART BOOK
July 2018
This resources was made possible by the Annie E. Casey Foundation, with additional support from the National Technical Assistance Network for Children’s Behavioral Health (TA Network) at the University of Maryland. The TA Network is funded by the Center for Mental Health Services (CMHS) at the U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) through Contract #HHSS C. The views, opinions, and content expressed here do not necessarily reflect the views, opinions, or policies of CMHS, SAMHSA, or HHS.

2. Since 2005, the Medicaid child population has increased by nearly 12%, yet the number of children receiving behavioral health care has increased by almost 33%.
CHART 1. TOTAL POPULATION OF CHILDREN IN MEDICAID COMPARED TO THE TOTAL CHILDREN RECEIVING BEHAVIORAL HEALTH CARE,
Children receiving behavioral health services
Children receiving psychotropic medications
Children receiving behavioral health care
Children in Medicaid
2005
2008
2011
29.0M
2.79M
30.5M
32.4M
1.96M
2.60M
2.06M
3.62M
2.59M
1.69M
1.84M
2.16M
This slide provides context with respect to overall findings, which we presented on last year. This year, we are going deeper into findings regarding racially/ethnically diverse children, psychotropic medications, and children in foster care.
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.

3. In 2011, 3.6 million children covered by Medicaid used behavioral health care, and of those children, 2.1 million received psychotropic medications. Of those children receiving these medications, nearly half (47%) received no accompanying behavioral health services.
CHART 2. ALL CHILDREN IN MEDICAID USING BEHAVIORAL HEALTH CARE, 2011 (N= 3,617,140)
Using behavioral health services N=2,594,817
Using psychotropic medication N=2,157,045
Behavioral health service use, no psychotropic medications
N=1,460,095
Behavioral health service use and psychotropic medications
N=1,134,722
Psychotropic medications use, no behavioral health services
N=1,022,323
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.

4. Behavioral health accounts for a disproportionate share of Medicaid spending for children, given the relatively small number of children who receive behavioral health care.
CHART 3. CHILDREN USING BEHAVIORAL HEALTH CARE AS A PROPORTION OF TOTAL MEDICAID ENROLLMENT,
Total Children in Medicaid = 32.4M
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.

5. Children in foster care and those with SSI/disability eligibility together represent only 8% of the Medicaid child population, but their care accounts for 49% of total behavioral health spending.
CHART 4. MEDICAID ENROLLMENT, BEHAVIORAL HEALTH SERVICE USE, AND EXPENSE BY AID CATEGORY, 2011
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.

6. Adolescents, ages 13-18, represent 22% of the overall Medicaid child population, but account for 38% of children in Medicaid using behavioral health services, and nearly 50% of total behavioral health care expenditures.
CHART 5. MEDICAID ENROLLMENT, BEHAVIORAL HEALTH SERVICE USE AND EXPENSE BY AGE GROUP, 2011
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.

7. Children in Medicaid are more likely to receive traditional behavioral health services, like outpatient treatment and psychotropic medications, vs. alternative evidence-based approaches.
CHART 6. USE OF TRADITIONAL BEHAVIORAL HEALTH SERVICES VS. EVIDENCE-BASED SERVICES, 2011
TRADITIONAL SERVICES
EVIDENCE-BASED SERVICES
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.

8. Children in Medicaid from racially/ethnically diverse backgrounds are less likely than white children to use behavioral health services.
CHART 7. MEDICAID ENROLLMENT AND BEHAVIORAL HEALTH SERVICE USE BY RACE/ETHNICITY, 2011
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.

9. Residential treatment/therapeutic group care — used by just over 4% of children — account for the largest proportion of expenditures at nearly 22% of total behavioral health expenditures.
CHART 8. COMPARISON OF USE AND EXPENSE FOR CHILDREN’S BEHAVIORAL HEALTH SERVICES IN MEDICAID WITH HIGHEST TOTAL EXPENDITURES, 2011
Source: Pires, S., McLean, J., and Allen, K., (2018) Faces of Medicaid Data Series: Examining Children’s Behavioral Health Service Use and Expenditures, Center for Health Care Strategies: Hamilton, NJ.