Medical expenditures attributable to cerebral palsy and intellectual disability among Medicaid-enrolled children.
Medicaid spends about three times more per year on a child who has both cerebral palsy and intellectual disability.
01Research in Context
What this study did
Kancherla et al. (2012) looked at Medicaid bills for children with cerebral palsy. They compared costs for kids who also had intellectual disability to kids who did not.
What they found
A child with both CP and ID cost Medicaid about three times more each year than a child with CP alone. The extra money pays for more hospital stays, therapy, and doctor visits.
How this fits with other research
Tonmukayakul et al. (2018) pooled 22 studies and found the same rule: the more severe the CP, the bigger the bill. Their review includes the 2012 Medicaid numbers, so the triple-cost finding still holds.
Lee et al. (2022) asked a new question: do kids with ID get the care they need? They found children with ID alone were almost four times more likely to miss needed care than kids with autism alone. Vijaya’s cost spike and K’s access gap sit side-by-side: money goes up, but care can still fall through.
Shawler et al. (2021) followed people into adulthood. Adults with CP plus ID had the highest rates of mental-health disorders. The childhood cost surge Vijaya saw is likely to continue as these clients need psychiatric services later on.
Why it matters
When you write a treatment plan, expect roughly triple the service intensity if CP and ID co-occur. Use the numbers to justify added therapy hours, respite, or equipment to funders. Flag the family for care-coordination early; high cost often hides unmet needs that Lee et al. (2022) uncovered.
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02At a glance
03Original abstract
This study estimated medical expenditures attributable to cerebral palsy (CP) among children enrolled in Medicaid, stratified by the presence of co-occurring intellectual disability (ID), relative to children without CP or ID. The MarketScan(®) Medicaid Multi-State database was used to identify children with CP for 2003-2005 by using the International Classification of Diseases, Ninth Revision; Clinical Modification (ICD-9-CM) code 343.xx. Children with ID were identified for 2005 by using ICD-9-CM code 317.xx-319.xx. Children without CP or ID during the same period served as control subjects. Medical expenditures were estimated for case and control children for 2005. The difference between the average expenditures for children with and without CP was used as a proxy for attributable expenditures for the condition. The attributable expenditures of co-occurring ID were calculated similarly as the difference in average expenditures among children with CP with and without ID. A total of 9927 children with CP were identified. Among them, 2022 (20.3%) children had co-occurring ID recorded in medical claims. Children with CP but without ID incurred medical expenditures that were $15,047 higher than those of control children without CP or ID. By contrast, children with CP and co-occurring ID incurred costs that were $41,664 higher, compared with control children, and $26,617 more than children with CP but without ID. Administrative data from a large, multistate database demonstrated high medical expenditures for publicly insured children with CP. Expenditures approximately tripled for children with CP and co-occurring ID.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.12.001