Healthcare utilization among children in foster care in the greater Houston area

•Claims-based examination of healthcare utilization among children in foster care.•The majority (58.8%) of outpatient encounters were provided in the home.•Sixty-one percent of children had their first healthcare encounter within 30 days. Children in foster care have greater physical and mental health conditions than children not in foster care. However, little is known about their actual healthcare utilization. This study describes healthcare utilization from July 1, 2014 to June 30, 2016 among children in foster care in the greater Houston, Texas area who receive Medicaid coverage through a single Medicaid managed care organization for children in foster care. Enrollment and claims data were used to describe demographic characteristics; outpatient utilization, location and type of encounters; inpatient utilization; and timeliness of first visit. Overall, 11,073 children were enrolled for any portion of the study period and 88% utilized healthcare services. Children who accessed healthcare services were significantly younger (p