ASPPH logo


Member Research & Reports

Member Research & Reports

WashU: Child Maltreatment Underreported in Medicaid Claims

Medicaid claims are a poor way to identify child abuse and neglect at a population level, according to a new study from the Brown School at Washington University in St. Louis. Maltreated children are frequent users of health and mental health services; almost all are entitled to Medicaid.

Ramesh Raghavan

[Photo: Dr. Ramesh Raghavan]

Researchers examined Medicaid records from 36 states for 1,921 children in the National Survey of Child and Adolescent Well-Being whom caseworkers had identified as having been maltreated, and who had received Medicaid-funded services.  Only 15 percent had relevant codes for abuse or neglect in any of their Medicaid files over four years of observation.

Medicaid records of maltreated boys, older children, and African Americans were less likely to reflect abuse than those of other children, the study found.

Previous research has documented the reasons clinicians may not enter maltreatment codes while billing Medicaid, but the magnitude at a national level has not been known.

“This study has important implications for Medicaid scholarship conducted on abused an neglected children,” wrote Dr. Ramesh Raghavan, associate professor at the Brown School and lead author of the study. “It seems clear that relying upon Medicaid claims yields unacceptably low rates of ascertained maltreatment.”

Instead, he wrote, researchers should include data from child welfare or other administrative data sets to better capture the prevalence of abuse or neglect at a population level.

The study was published online in the August issue of Child Maltreatment.

To read more, click:

Photo: Dr. Ramesh Raghavan