Beacon is the largest manager of autism insurance benefits in the country, with more than 30,000 individuals receiving care in our autism program annually. As part of our ABA Care Management model, we incorporate real-time clinical data—such as utilization and outcome trends—to ensure that services are being delivered effectively, and to gauge the progress of each individual case in our care.
In California where we’ve managed ABA benefits since 2012, Beacon recently conducted an in-depth clinical data analysis of our 340 active ABA cases across four commercially insured California health plans in 2014, with group data analyzed by an independent medical statistician. We found:
- There were 279 boys and 61 girls in the 2014 treatment cohort, similar to the Centers for Disease Control’s (CDC) finding of a 5:1 ratio of boys versus girls in the incidence of autism
- The penetration rate of members accessing ABA services within a covered benefit is significantly less than the prevalence reported by the CDC
- Treatment time is usually shorter than generally expected—our experience shows that children in active ABA treatment have an average episode length of 14 months
- The average cost per case across our California study was $19,000 to $20,000, compared to the CDC’s report that “intensive behavioral interventions for children with ASD cost $40,000 to $60,000 per child per year”
- To achieve meaningful results, 15 to 40 hours of ABA services are typically required per week—the average service utilization in California was 18 hours per week
- There were significant improvements in 14 different skillsets, including language/communication, social skills, toileting, math, and routine schedule
- There were significant reductions in seven critical types of maladaptive behaviors, including aggression, tantrum, self-injury, and non-compliance
Learn more about Beacon’s autism spectrum disorder services.