children’s psychiatric drugs in alaska medicaid: alaska’s own three numbers
alaska told cms three things about its children in the 2025 reporting year: 53.6 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 40th of the 50 states that reported it; 17.7 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, the fifth-lowest of the 49 states that reported it; 39.0 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 44th of the 51 states that reported it.[1]
across the whole age range, alaska sits below the national median on psychosocial care before an antipsychotic and in the bottom quarter of the country on the 30-day adhd follow-up. same state, same year, same children.
every row alaska sent to cms
| measure | alaska | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 53.6 | withheld | 40 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 61.9 | withheld | 33 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 59.8 | 582 | 33 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 17.7 | withheld | 45 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 29.3 | withheld | 43 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 26.3 | 897 | 43 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 44.3 | 897 | 47 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 27.1 | 897 | 43 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 39.0 | 502 | 44 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 91.5 | 118 | 1 of 49 | 55.5 |
rank 1 is the highest rate. how the ranks and the withheld cells work.[1]
talking treatment before the antipsychotic
for the youngest children, aged 1 to 11, alaska reported 53.6 percent — 5.6 points below the national median of 59.2, and 40th of the 50 states that reported it. put the other way round, 46.4 percent of the youngest children in alaska who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 61.9 percent. across ages 1 to 17, 59.8 percent on 582 children, 33rd of the 51 states that reported it. it reported 57.1 the year before on the same method, so this one moved 2.7 points up — the only one of the three where that comparison holds. either side of alaska on that row: north dakota at 60.4 and pennsylvania at 59.8.
the two blood tests
alaska reported that 17.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fifth-lowest of the 49 states that reported it, 11.4 points below the national median of 29.1. split into halves across ages 1 to 17, glucose ran 44.3 percent and cholesterol 27.1 percent, both on 897 children — the fourth-lowest of the 51 states that reported it on glucose, 43rd of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 26.3 percent. either side of alaska on the both-tests row for ages 1 to 17: mississippi at 27.5 and iowa at 25.4.
the 30-day visit after a new adhd prescription
39.0 percent, on 502 children aged 6 to 12 who were newly prescribed an adhd medicine in alaska — 44th of the 51 states that reported it, 8.6 points below the national median of 47.6. that leaves 61.0 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 91.5 percent had at least two more visits on 118 children, against a national median of 55.5 — the highest of the 49 states that reported it. either side of alaska on the 30-day row: minnesota at 39.1 and massachusetts at 38.4.
what medicaid paid for in alaska in 2024
in 2024 medicaid in alaska paid for 22,379 hydroxyzine prescriptions, $471,213 worth, and 24,984 benzodiazepine prescriptions, $539,239 worth — 89.6 hydroxyzine prescriptions for every 100 benzodiazepine ones. 77 of the 229 hydroxyzine rows and 425 of the 851 benzodiazepine rows for alaska were suppressed, so both are floors.[2] our own sums of the federal file, which has no ages, so neither is a children’s number, and no rank.
four things to ask, with alaska’s own numbers behind them
ask which drug it is, not which class
alaska, 2024: 22,379 hydroxyzine prescriptions and 24,984 benzodiazepine prescriptions
hydroxyzine is an antihistamine; a benzodiazepine brings dependence and withdrawal. read the name on the bottle. why they get merged.
if an antipsychotic is being started, ask what came first
alaska: 53.6 percent of children aged 1 to 11, 40th of the 50 states that reported it
in 46.4 percent of these cases the answer is “none yet”. ask what was tried first, and ask for it in the notes.
if your child is on an antipsychotic, get the date of the bloodwork
alaska: 17.7 percent of children aged 1 to 11 had both tests, the fifth-lowest of the 49 states that reported it
missed 82.3 percent of the time in alaska. ask when the glucose and cholesterol test is booked, and leave with a date.
if an adhd medicine has just been started, book the 30-day visit now
alaska: 39.0 percent, 44th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and alaska misses it 61.0 percent of the time. book it before you leave the room.
how to read any of this
self-reported, on methods that differ by state, and process not outcome.[1] method and suppression rules; the national picture.
questions people ask
In Alaska, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Alaska reported 53.6 percent for children aged 1 to 11, against a national median of 59.2 percent — 40th of the 50 states that reported it. For ages 12 to 17 it was 61.9 percent, and across ages 1 to 17 59.8 percent on 582 children.
In Alaska, do children on antipsychotics get the blood tests?
17.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fifth-lowest of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 44.3 percent, cholesterol 27.1 percent, on 897 children.
In Alaska, how often does the 30-day ADHD follow-up visit happen?
39.0 percent of the time, on 502 children aged 6 to 12 newly prescribed an ADHD medicine — 44th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 91.5 percent in Alaska against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Alaska rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 53.6 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 61.9 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 59.8 on a denominator of 582; APM-CH both blood tests, 1 to 11: 17.7 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 29.3 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 26.3 on a denominator of 897; APM-CH glucose alone, 1 to 17: 44.3 on a denominator of 897; APM-CH cholesterol alone, 1 to 17: 27.1 on a denominator of 897; ADD-CH 30-day adhd follow-up, 6 to 12: 39.0 on a denominator of 502; ADD-CH nine-month adhd follow-up, 6 to 12: 91.5 on a denominator of 118. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Alaska rows, summed by product name, read 2026-09-28: hydroxyzine 22,379 prescriptions, $471,213, 77 of 229 rows suppressed; benzodiazepines 24,984 prescriptions, $539,239, 425 of 851 rows suppressed. Our sum, not a CMS statistic. https://data.medicaid.gov/dataset/61729e5a-7aa8-448c-8903-ba3e0cd0ea3c
all 51 states ranked · what the national numbers say
nothing here is a reason to start, stop or change a child’s medication. it is a set of questions to bring to the person who prescribes it.
adam