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Applied Behavior Analysis Services in Kansas (March 2019)

By Sydney McClendon, Madison Hoover, M.S., Steve Corbett, Ph.D., Wen-Chieh Lin, Ph.D. | March 26, 2019

Applied Behavior Analysis Services in Kansas (March 2019)

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As the prevalence of autism spectrum disorder (ASD) has increased — up from 1 in 150 children in 2000 to 1 in 59 in 2014 — so has a national push for coverage of ASD services, including applied behavior analysis (ABA). ABA is an intensive treatment that utilizes principles of behavior and learning to modify socially significant behaviors (e.g., using positive reinforcement to encourage a desired behavior). It is typically provided in one-on-one sessions, using treatment programs ranging from 10 to 40 hours per week.

ABA is provided via a tiered service-delivery model, with behavior analysts creating and monitoring treatment plans carried out by technicians. While there are limitations with the current evidence assessing ABA, to date it appears to be the most effective treatment mechanism for ASD. In particular, ABA benefits preschool age children, and early intervention might reduce long-term costs associated with ASD.

The costs of providing ABA are high ($40,000 to $60,000 per year), however, and across the U.S. states struggle to provide ABA to individuals who need it. The cost of providing ABA, few ABA providers and long waitlists all have been cited as reasons for the lack of access. The same issues appear to be present in Kansas, even in the wake of legislative and administrative changes intended to improve coverage for ABA.  

Key findings from the report include:

  • In 2017, 5,405 individuals age 0-21 in KanCare had an ASD diagnosis, and 153 received ABA. While not all individuals with an ASD diagnosis likely required ABA due to medical necessity, the number receiving ABA remains low. 
  • Most respondents to the ABA provider survey indicated that they have a waitlist, with average wait times close to two years (22.3 months) in KanCare and over a year and a half (19.4 months) for private insurance.
  • Respondents to the ABA provider survey who accept KanCare and/or private insurance indicated that reimbursement levels and a lack of qualified staff were the most prominent barriers to providing ABA services.
  • Respondents to the ABA provider survey indicated that waitlists and distance to providers were the most significant barriers families with KanCare face, while lack of coverage for ABA services and financial burden were the most significant barriers for families with private insurance.

The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.