children’s psychiatric drugs in ohio medicaid: ohio’s own three numbers
ohio told cms three things about its children in the 2025 reporting year: 73.9 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 6th of the 50 states that reported it; 29.6 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 23rd of the 49 states that reported it; 53.6 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 14th of the 51 states that reported it.[1]
across the whole age range, ohio sits in the top quarter of the country on psychosocial care before an antipsychotic and below the national median on the two metabolic blood tests. same state, same year, same children.
every row ohio sent to cms
| measure | ohio | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 73.9 | withheld | 6 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 76.7 | withheld | 5 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 75.6 | 7,059 | 6 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 29.6 | withheld | 23 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 34.0 | withheld | 30 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 32.4 | 19,733 | 27 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 53.6 | 19,733 | 30 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 33.6 | 19,733 | 28 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 53.6 | 21,122 | 14 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 61.2 | 6,969 | 12 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, ohio reported 73.9 percent — 14.7 points above the national median of 59.2, and 6th of the 50 states that reported it. put the other way round, 26.1 percent of the youngest children in ohio who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 76.7 percent. across ages 1 to 17, 75.6 percent on 7,059 children, 6th of the 51 states that reported it. it reported 73.2 the year before on the same method, so this one moved 2.4 points up — the only one of the three where that comparison holds. either side of ohio on that row: vermont at 78.2 and maryland at 71.8.
the two blood tests
ohio reported that 29.6 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 23rd of the 49 states that reported it, 0.5 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 53.6 percent and cholesterol 33.6 percent, both on 19,733 children — 30th of the 51 states that reported it on glucose, 28th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 32.4 percent. either side of ohio on the both-tests row for ages 1 to 17: illinois at 32.4 and nevada at 32.1.
the 30-day visit after a new adhd prescription
53.6 percent, on 21,122 children aged 6 to 12 who were newly prescribed an adhd medicine in ohio — 14th of the 51 states that reported it, 6.0 points above the national median of 47.6. that leaves 46.4 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 61.2 percent had at least two more visits on 6,969 children, against a national median of 55.5 — 12th of the 49 states that reported it. either side of ohio on the 30-day row: kentucky at 53.7 and kansas at 53.0.
what medicaid paid for in ohio in 2024
in 2024 medicaid in ohio paid for 550,580 hydroxyzine prescriptions, $6,874,263 worth, and 619,420 benzodiazepine prescriptions, $9,717,854 worth — 88.9 hydroxyzine prescriptions for every 100 benzodiazepine ones. 148 of the 627 hydroxyzine rows and 884 of the 2,513 benzodiazepine rows for ohio 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 ohio’s own numbers behind them
ask which drug it is, not which class
ohio, 2024: 550,580 hydroxyzine prescriptions and 619,420 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
ohio: 73.9 percent of children aged 1 to 11, 6th of the 50 states that reported it
in 26.1 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
ohio: 29.6 percent of children aged 1 to 11 had both tests, 23rd of the 49 states that reported it
missed 70.4 percent of the time in ohio. 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
ohio: 53.6 percent, 14th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and ohio misses it 46.4 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 Ohio, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Ohio reported 73.9 percent for children aged 1 to 11, against a national median of 59.2 percent — 6th of the 50 states that reported it. For ages 12 to 17 it was 76.7 percent, and across ages 1 to 17 75.6 percent on 7,059 children.
In Ohio, do children on antipsychotics get the blood tests?
29.6 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 23rd of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 53.6 percent, cholesterol 33.6 percent, on 19,733 children.
In Ohio, how often does the 30-day ADHD follow-up visit happen?
53.6 percent of the time, on 21,122 children aged 6 to 12 newly prescribed an ADHD medicine — 14th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 61.2 percent in Ohio against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Ohio rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 73.9 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 76.7 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 75.6 on a denominator of 7,059; APM-CH both blood tests, 1 to 11: 29.6 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 34.0 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 32.4 on a denominator of 19,733; APM-CH glucose alone, 1 to 17: 53.6 on a denominator of 19,733; APM-CH cholesterol alone, 1 to 17: 33.6 on a denominator of 19,733; ADD-CH 30-day adhd follow-up, 6 to 12: 53.6 on a denominator of 21,122; ADD-CH nine-month adhd follow-up, 6 to 12: 61.2 on a denominator of 6,969. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Ohio rows, summed by product name, read 2026-09-28: hydroxyzine 550,580 prescriptions, $6,874,263, 148 of 627 rows suppressed; benzodiazepines 619,420 prescriptions, $9,717,854, 884 of 2,513 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