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(SDAS) Medical Care Utilization and Costs among Transition-age Young Adult Medicare Beneficiaries with Autism Spectrum Disorder


  • Young Adulthood (19-25 years)


Improving utilization and access to effective care for children and youth with autism spectrum disorder (ASD), while minimizing costs, are important health policy objectives identified by the Maternal and Child Health Bureau (MCHB). We know that children with ASD have increased utilization and costs for a variety of services compared to other children with special health needs and the non-ASD population (e.g., Croen et al., 2006; Liptak et al., 2008), and that disparities exist in utilization of needed services for children (Magana, Parish, Rose, Timberlake & Swaine, 2012; Mandell, Wiggins, Carpenter et al., 2009; Montes & Halterman, 2011). However, little is known about the patterns of health care utilization and expenditures for persons with autism spectrum disorder (ASD) transitioning from pediatric to adult care, or whether disparities continue into young adulthood. The purpose of this project is to examine patterns of health care utilization and expenditures in the target population, young adults with ASD between the ages of 18-25 years of age. This project is the first to examine utilization and costs within a transition-age population of young adults with ASD, and to identify racial and ethnic differences in utilization and costs within this group. Understanding utilization and costs during the health care transition from pediatric to adult care will provide a first step in informing practice through highlighting service needs and barriers, and is identified as an important objective of the Interagency Coordinating Council (IACC, 2014) and HRSA/MCHB (Core Outcome: "Youth with special health care needs receive the services necessary to make transitions to adult health care"). This study will also inform legal care planning needs for families with young adult children with ASD. The specific aims are to: 1) Summarize utilization and cost of services (hospital-based services, ambulatory services, therapy services) among young adults with autism spectrum disorder (ASD) aged 18-25 years in Medicare fee-for-service 5% national sample of beneficiaries' claims (years 2008-2010), and examine differences in utilization and costs among racial and ethnic subgroups; and 2) To compare utilization and costs between young adults with ASD with an age, sex and comorbidity matched sample of persons with intellectual disability (ID). Preliminary studies indicate that the unweighted Medicare 5% study sample age 18-25 includes 283 unique persons with ASD and 526 unique persons with ID among Medicare beneficiaries with 1 to 12 months of FFS eligibility for 2008 to 2010. This retrospective study of existing secondary data will use descriptive and multivariate generalized estimating equations to examine utilization in the study population.


Listed is descending order by year published.

Benevides TW, Carretta HJ, Graves KY. Case identification and characterization of autistic young adults in 2010 Medicare fee-for-service claims. Autism Adulthood. 20 Mar 2019.

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