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The Periodic Risk Evaluation: A new tool to link Medicaid-enrolled autistic adults to services and support
Journal article   Open access   Peer reviewed

The Periodic Risk Evaluation: A new tool to link Medicaid-enrolled autistic adults to services and support

Lindsay Shea, Kaitlin Koffer Miller, Stacy Nonnemacher, Alec Becker, Pamela Treadway, Amy Alford, Craig Newschaffer and Brian K. Lee
Research in autism spectrum disorders, v 98
Oct 2022
DOI: https://doi.org/10.1016/j.rasd.2022.102037
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.rasd.2022.102037View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Adult Autism Medicaid Risk Service use
The Periodic Risk Evaluation (PRE) is a new questionnaire-based tool to identify autistic adults enrolled in Medicaid programs who are at risk for adverse outcomes including mental health and medical conditions, law enforcement interaction, stressful life events, substance use, presence of natural supports, and suboptimal living conditions. The PRE is completed by direct service providers and informs case conceptualization to drive changes in needed supports. The PRE was tested in a sample of 674 autistic adults with a mean age of 31 years across a large, northeastern state. A random forest model was developed to predict complex case status using the PRE items. Sensitivity, specificity, positive predictive value, and negative predictive value for different PRE score cutoffs were evaluated as the performance measures of interest. Expert clinical assessment, the gold standard for case status, identified 131 individuals (19.4 %) as complex cases in need of modified services and supports. The final PRE model identified complex cases in unseen data with 75.5 % accuracy, 71.9 % sensitivity, 76.3 % specificity, 41.8 % positive predictive value, and 92.0 % negative predictive value. The PRE may be a useful tool for triaging service needs and delivery to adults on the spectrum. The use of the PRE in the Medicaid system is critical because Medicaid is among the only insurers available during the transition to and throughout adulthood for autistic individuals. Adequate planning and assessment of risk can assist direct support staff in triaging and mitigating risk to minimize adverse outcomes. •The Periodic Risk Evaluation assesses risk among Medicaid-enrolled autistic adults.•Risk assessed in the PRE include mental health crisis and police interaction.•The PRE exhibited acceptable but not high sensitivity and specificity to identify complex cases.•Initial findings show the PRE has the potential to triage service needs for autistic individuals.

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13 Record Views
2 citations in Web of Science
3 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

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Collaboration types
Domestic collaboration
Web of Science research areas
Education, Special
Psychiatry
Psychology, Developmental
Rehabilitation
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