children’s psychiatric drugs in oregon medicaid: oregon’s own three numbers
oregon told cms three things about its children in the 2025 reporting year: 64.2 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 18th of the 50 states that reported it; 27.7 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 27th of the 49 states that reported it; 57.9 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, the fifth-highest of the 51 states that reported it.[1]
across the whole age range, oregon sits in the top quarter of the country on the 30-day adhd follow-up and below the national median on the two metabolic blood tests. same state, same year, same children.
every row oregon sent to cms
| measure | oregon | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 64.2 | withheld | 18 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 69.1 | withheld | 16 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 67.6 | 1,058 | 16 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 27.7 | withheld | 27 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 32.9 | withheld | 33 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 31.4 | 3,133 | 32 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 53.5 | 3,133 | 32 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 32.2 | 3,133 | 32 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 57.9 | 4,466 | 5 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 64.7 | 1,468 | 4 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, oregon reported 64.2 percent — 5.0 points above the national median of 59.2, and 18th of the 50 states that reported it. put the other way round, 35.8 percent of the youngest children in oregon who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 69.1 percent. across ages 1 to 17, 67.6 percent on 1,058 children, 16th of the 51 states that reported it. it reported 65.9 the year before on the same method, so this one moved 1.7 points up — the only one of the three where that comparison holds. either side of oregon on that row: colorado at 68.6 and michigan at 67.4.
the two blood tests
oregon reported that 27.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 27th of the 49 states that reported it, 1.4 points below the national median of 29.1. split into halves across ages 1 to 17, glucose ran 53.5 percent and cholesterol 32.2 percent, both on 3,133 children — 32nd of the 51 states that reported it on glucose, 32nd of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 31.4 percent. either side of oregon on the both-tests row for ages 1 to 17: kentucky at 31.8 and indiana at 30.9.
the 30-day visit after a new adhd prescription
57.9 percent, on 4,466 children aged 6 to 12 who were newly prescribed an adhd medicine in oregon — the fifth-highest of the 51 states that reported it, 10.3 points above the national median of 47.6. that leaves 42.1 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 64.7 percent had at least two more visits on 1,468 children, against a national median of 55.5 — the fourth-highest of the 49 states that reported it. either side of oregon on the 30-day row: arizona at 58.8 and maine at 57.7.
what medicaid paid for in oregon in 2024
in 2024 medicaid in oregon paid for 154,124 hydroxyzine prescriptions, $1,220,177 worth, and 139,032 benzodiazepine prescriptions, $1,473,180 worth — 110.9 hydroxyzine prescriptions for every 100 benzodiazepine ones. 148 of the 482 hydroxyzine rows and 888 of the 1,707 benzodiazepine rows for oregon 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 oregon’s own numbers behind them
ask which drug it is, not which class
oregon, 2024: 154,124 hydroxyzine prescriptions and 139,032 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
oregon: 64.2 percent of children aged 1 to 11, 18th of the 50 states that reported it
in 35.8 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
oregon: 27.7 percent of children aged 1 to 11 had both tests, 27th of the 49 states that reported it
missed 72.3 percent of the time in oregon. 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
oregon: 57.9 percent, the fifth-highest of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and oregon misses it 42.1 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 Oregon, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Oregon reported 64.2 percent for children aged 1 to 11, against a national median of 59.2 percent — 18th of the 50 states that reported it. For ages 12 to 17 it was 69.1 percent, and across ages 1 to 17 67.6 percent on 1,058 children.
In Oregon, do children on antipsychotics get the blood tests?
27.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 27th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 53.5 percent, cholesterol 32.2 percent, on 3,133 children.
In Oregon, how often does the 30-day ADHD follow-up visit happen?
57.9 percent of the time, on 4,466 children aged 6 to 12 newly prescribed an ADHD medicine — the fifth-highest of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 64.7 percent in Oregon against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Oregon rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 64.2 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 69.1 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 67.6 on a denominator of 1,058; APM-CH both blood tests, 1 to 11: 27.7 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 32.9 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 31.4 on a denominator of 3,133; APM-CH glucose alone, 1 to 17: 53.5 on a denominator of 3,133; APM-CH cholesterol alone, 1 to 17: 32.2 on a denominator of 3,133; ADD-CH 30-day adhd follow-up, 6 to 12: 57.9 on a denominator of 4,466; ADD-CH nine-month adhd follow-up, 6 to 12: 64.7 on a denominator of 1,468. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Oregon rows, summed by product name, read 2026-09-28: hydroxyzine 154,124 prescriptions, $1,220,177, 148 of 482 rows suppressed; benzodiazepines 139,032 prescriptions, $1,473,180, 888 of 1,707 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