Behavioral Health Screening among Massachusetts Children Receiving Medicaid

UMMS Affiliation

Department of Family Medicine and Community Health; Commonwealth Medicine, Center for Health Policy and Research

Publication Date


Document Type



Health Policy | Health Services Administration | Health Services Research | Mental and Social Health | Pediatrics | Primary Care | Psychiatry and Psychology


OBJECTIVE: To assess the impact of a Massachusetts Medicaid policy change (the Children's Behavioral Health Initiative; CBHI, which required and reimbursed behavioral health [BH] screening with standardized tools at well child visits and developed intensive home- and community-based BH services) on primary care practice examining the relationship of BH screening to subsequent BH service utilization.

STUDY DESIGN: Using a repeated cross-sectional design, our 2010 and 2012 Medicaid study populations each included 2000 children/adolescents under the age of 21 years. For each year, the population was randomly selected and stratified into 4 age groups, with 500 members selected per group. Two data sources were used: medical records and Medicaid claims.

RESULTS: The CBHI had a large impact on formal BH screening and treatment utilization among children/adolescents enrolled in Medicaid. Screening increased substantially (73%: 2010; 74%: 2012) since the baseline/premandate period (2007) when only 4% of well child visits included a formal screen. BH utilization increased among those formally screened but decreased among those with informal assessments.

CONCLUSIONS: CBHI implementation transformed the relationship between primary care and BH services. Changes in regulation and payment resulted in widespread BH screening in Massachusetts primary care practices caring for children/adolescents on Medicaid.


Behavioral Health, Children and Families, Medicaid

DOI of Published Version



J Pediatr. 2016 Nov;178:261-267. doi: 10.1016/j.jpeds.2016.07.029. Epub 2016 Aug 18. Link to article on publisher's site

Journal/Book/Conference Title

The Journal of pediatrics

Related Resources

Link to Article in PubMed

PubMed ID