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• W2914626570 abstract "Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the passage of the comprehensive federal Mental Health Parity and Addiction Equity Act (MHPAEA), implemented in 2010. A patchwork of state mental health parity laws preceded MHPAEA, none of which applied to employer-sponsored plans governed by the federal Employee Retirement Income Security Act (also known as self-insured plans). Parity policies aim to improve financial protection and increase access to and utilization of behavioral health services for persons with mental health conditions. The objective of this study was to determine the effects of MHPAEA on use of and out-of-pocket spending on mental health care services.We conducted a before-after with comparison group study of commercially-insured enrollees in 24 states where self-insured employers were newly subject to parity under MHPAEA but small employer plans were exempt both before and after MHPAEA. Our “intervention” group comprised propensity score matched behavioral health patients enrolled through self-insured employers (n=11,326) that we followed for 1 year before and 1-2 years after MHPAEA. “Comparison” group members comprised similar patients in small-employer plans (n=11,326). We calculated changes in out-of-pocket costs and utilization using adjusted difference-in-differences analyses. We found that, relative to comparison group enrollees, mean out-of-pocket spending per outpatient mental health visit declined among intervention group enrollees by $0.72 (p<0.05) 1 year and $4.25 (p<0.001) 2 years after MHPAEA. In the intervention group, mental health outpatient visits per enrollee increased by 0.27 visits (p<0.01) 1 year and 0.40 visits (p<0.001) 2 years after MHPAEA (relative increases of 3.74% and 5.80%, respectively). We did not detect significant changes in total outpatient mental health out-of-pocket spending, ED visits, or hospitalizations. We conclude that among the commercially insured population, MHPAEA had modest effects on reducing out-of-pocket costs and increasing access to use of outpatient mental health services. These dynamics may presage the effects of extending parity to underserved populations under the Affordable Care Act. Comprehensive federal parity addressed some gaps created by heterogeneous state policies and served to moderately increase financial protection and use of mental health services. Ultimately, parity policies cannot alone solve access and utilization deficits in mental health care in the U.S. Addressing other barriers to care, such as provider under-supply and stigma, will supplement the effects of parity in mental health insurance coverage." @default.
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• W2914626570 date "2015-06-28" @default.
• W2914626570 modified "2023-09-23" @default.
• W2914626570 title "Effects of Federal Mental Health Parity on Mental Health Care Use and Spending" @default.
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