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- Title
Carve-out plan financial requirements associated with national behavioral health parity.
- Authors
Friedman, Sarah; Xu, Haiyong; Azocar, Francisca; Ettner, Susan L.
- Abstract
<bold>Objectives: </bold>To examine changes in carve-out financial requirements (copayments, coinsurance, use of deductibles, and out-of-pocket maxima) following the Mental Health Parity and Addiction Equity Act (MHPAEA).<bold>Data Source/study Setting: </bold>Specialty mental health benefit design information for employer-sponsored carve-out plans from a national managed behavioral health organization's claims processing engine (2008-2013).<bold>Study Design: </bold>This pre-post study reports linear and logistic regression as the main analysis.<bold>Data Collection/extraction Methods: </bold>NA.<bold>Principal Findings: </bold>Copayments for in-network emergency room (-$44.9, 95% CI: -78.3, -11.5; preparity mean: $56.2), outpatient services (eg, individual psychotherapy: -$7.4, 95% CI: -10.5, -4.2; preparity mean: $17.8), and out-of-network coinsurance for emergency room (-11 percentage points, 95% CI: -16.7, -5.4; preparity mean: 38.8 percent) and outpatient (eg, individual psychotherapy: -5.8 percentage points, 95% CI: -10.0, -1.6; preparity mean 41.0 percent) decreased. Probability of family OOP maxima use (29 percentage points, 95% CI: 19.3, 38.6; preparity mean: 36 percent) increased. In-network outpatient coinsurance increased (eg, individual psychotherapy: 4.5 percentage points, 95% CI: 1.1, 7.9; preparity mean: 2.7 percent), as did probability of use of family deductibles (15 percentage points, 95% CI: 6.1, 23.3; preparity mean: 38 percent).<bold>Conclusions: </bold>MHPAEA was associated with increased generosity in most financial requirements observed here. However, increased use of deductibles may have reduced generosity for some patients.
- Subjects
UNITED States; LOGISTIC regression analysis; FINANCIAL planning; OUTPATIENT medical care; HOSPITAL emergency services; MENTAL health; MEDICAL care cost statistics; MENTAL health service laws; EMPLOYER-sponsored health insurance statistics; EMPLOYER-sponsored health insurance laws; INSURANCE statistics; MENTAL health services administration; INSURANCE; MENTAL health services; ECONOMICS
- Publication
Health Services Research, 2020, Vol 55, Issue 6, p924
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13542