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Carve‐out plan financial requirements associated with national behavioral health parity
Author(s) -
Friedman Sarah,
Xu Haiyong,
Azocar Francisca,
Ettner Susan L.
Publication year - 2020
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13542
Subject(s) - managed care , health plan , medicine , mental health , generosity , logistic regression , cost sharing , equity (law) , specialty , health care , finance , actuarial science , demography , psychiatry , business , economics , nursing , political science , economic growth , sociology , law
Objectives 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). Data Source/Study Setting 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). Study Design This pre‐post study reports linear and logistic regression as the main analysis. Data Collection/Extraction Methods NA. Principal Findings 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). Conclusions MHPAEA was associated with increased generosity in most financial requirements observed here. However, increased use of deductibles may have reduced generosity for some patients.