MassHealth initiative substantially increases behavioral health screening for children, according to study led by UMass Medical School

August 30, 2016

The Massachusetts Medicaid program’s Children’s Behavioral Health Initiative (CBHI) has substantially increased the percentage of children receiving behavioral health screening, according to a study led by UMass Medical School to be published in The Journal of Pediatrics and available online ahead of print.

“CBHI implementation transformed the relationship between primary care and BH (behavioral health) services,” the authors of the study concluded. “Changes in regulation and payment resulted in widespread BH screening in Massachusetts primary care practices caring for children/adolescents on Medicaid.”

The lead author is Judith A. Savageau, MPH, research associate professor in Family Medicine and Community Health at UMass Medical School and research faculty in the Center for Health Policy and Research at UMass Medical School’s Commonwealth Medicine division.

In late December 2007, CBHI began requiring and reimbursing behavioral health screening with standardized tools for children and adolescents enrolled in MassHealth, Massachusetts’ Medicaid program, during well-child visits. Only 4 percent of well-child visits included formal behavioral health screening in 2007, but screening jumped to 73 percent in 2010 and 74 percent in 2012, the study found.

According to published literature, between 13 and 24 percent of children in the U.S. have behavioral health conditions, but many of them do not receive treatment. Undertreatment increases the risk of significant medical, psychosocial, educational and social consequences while early intervention among children with behavioral health problems results in better outcomes, the authors said.

Researchers analyzed data from 2010 and 2012 medical records and MassHealth claims for 4,000 children and adolescents under age 21 for the study, and compared this to their baseline study using 2007 data.

Commonwealth Medicine co-authors are Georgianna Willis, PhD, project director in the Center for Health Policy and Research; Kathleen Muhr, MEd, project director in Work Without Limits; and Gideon Aweh, MS, biostatistician in the Center for Health Policy and Research. Other co-authors are David Keller, MD, professor of pediatrics and first vice chair for Clinical Affairs and Clinical Transformation of the Department of Pediatrics at the University of Colorado School of Medicine, a member of the Department of Pediatrics at UMass Memorial Medical Center when the study was conducted; Jack Simons, PhD, director of the Children’s Behavioral Health Initiative at MassHealth; and Emily Sherwood, MPA, director of the Children’s Behavioral Health Interagency Initiative at the Massachusetts Executive Office of Health and Human Services.