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The Mental Health Parity and Addiction Equity Act evaluation study: Child and adolescent behavioral health service expenditures and utilization

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  • Eryn Piper Block
  • Haiyong Xu
  • Francisca Azocar
  • Susan L. Ettner

Abstract

This study explores possible associations of the Mental Health Parity and Addiction Equity Act (MHPAEA) with child access to behavioral health (BH) services (preimplementation = 2008–2009, transition = 2010, and post = 2011–2013). The study sample included children aged 4–17 years in self‐insured “carve‐in” plans from large employers. In “carve‐ins,” BH and medical care are covered through the same insurance plan. The unit of analysis is the person‐month (N = 61,823,533). This study employs an interrupted time series model allowing for intercept and slope changes for the transition and postparity periods. Outcomes included total, plan and patient out‐of‐pocket (OOP) expenditures, and several categories of service utilization. Generalized estimating equations were used to account for clustering. There were significant increases in total and plan expenditures postparity. To illustrate, in July 2012, mean per‐member‐per‐month total expenditures were predicted to be $5.65 without parity but $8.72 with parity. Patient OOP costs did not change significantly. Significant overall increases were seen for utilization of most outpatient services but not intermediate or inpatient services. Our findings suggest that the introduction of MHPAEA was associated with an increase in specialty BH service access for children without a commensurate increase in financial burden for families.

Suggested Citation

  • Eryn Piper Block & Haiyong Xu & Francisca Azocar & Susan L. Ettner, 2020. "The Mental Health Parity and Addiction Equity Act evaluation study: Child and adolescent behavioral health service expenditures and utilization," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1533-1548, December.
  • Handle: RePEc:wly:hlthec:v:29:y:2020:i:12:p:1533-1548
    DOI: 10.1002/hec.4153
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    References listed on IDEAS

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    1. A. Colin Cameron & Douglas L. Miller, 2015. "A Practitioner’s Guide to Cluster-Robust Inference," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 317-372.
    2. repec:mpr:mprres:7668 is not listed on IDEAS
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    1. Chris Sampson’s journal round-up for 7th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-07 12:00:03

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