IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/23094.html
   My bibliography  Save this paper

Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers

Author

Listed:
  • Johanna Catherine Maclean
  • Ioana Popovici
  • Elisheva Rachel Stern

Abstract

We examine how substance use disorder (SUD) treatment providers respond to private insurance expansions induced by state equal coverage (‘parity’) laws for SUD treatment vis-à-vis general healthcare services. Economic theory suggests that such laws will lead to changes in provider behaviors. We use data on licensed specialty SUD treatment providers in the United States between 1997 and 2010 in a differences-in-differences analysis. During this period, 12 states implemented laws that require equality in coverage for SUD treatment. Following the passage of a state parity law we find that providers are less likely to participate in public markets, are less likely to offer price discounts to patients, and increase the quantity of healthcare provided. Further we find evidence that treatment intensity declines following passage of a parity law and heterogeneity in effects across ownership status.

Suggested Citation

  • Johanna Catherine Maclean & Ioana Popovici & Elisheva Rachel Stern, 2017. "Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers," NBER Working Papers 23094, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:23094
    Note: EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w23094.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Thomas C. Buchmueller & Sarah Miller & Marko Vujicic, 2014. "How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits," NBER Working Papers 20053, National Bureau of Economic Research, Inc.
    2. Brendan Saloner & Yaa Akosa Antwi & Johanna Catherine Maclean & Benjamin Lê Cook, 2015. "Access to health insurance and utilization of public sector substance use treatment: Evidence from the Affordable Care Act dependent coverage provision," DETU Working Papers 1509, Department of Economics, Temple University.
    3. Dhaval Dave & Swati Mukerjee, 2011. "Mental health parity legislation, cost‐sharing and substance‐abuse treatment admissions," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 161-183, February.
    4. Rosalie Liccardo Pacula & Jamie F. Chriqui & Joanna King, 2003. "Marijuana Decriminalization: What does it mean in the United States?," NBER Working Papers 9690, National Bureau of Economic Research, Inc.
    5. Christopher Carpenter, 2007. "Heavy Alcohol Use and Crime: Evidence from Underage Drunk-Driving Laws," Journal of Law and Economics, University of Chicago Press, vol. 50(3), pages 539-557.
    6. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
    7. Sloan, Frank A. & Picone, Gabriel A. & TaylorJr., Donald H. & Chou, Shin-Yi, 2001. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?," Journal of Health Economics, Elsevier, vol. 20(1), pages 1-21, January.
    8. Laurence C. Baker & Anne Beeson Royalty, 2000. "Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 480-502.
    9. Scott Adams & McKinley L. Blackburn & Chad D. Cotti, 2012. "Minimum Wages and Alcohol-Related Traffic Fatalities among Teens," The Review of Economics and Statistics, MIT Press, vol. 94(3), pages 828-840, August.
    10. Freedman, Seth & Lin, Haizhen & Simon, Kosali, 2015. "Public health insurance expansions and hospital technology adoption," Journal of Public Economics, Elsevier, vol. 121(C), pages 117-131.
    11. Rosalie L. Pacula & David Powell & Paul Heaton & Eric L. Sevigny, 2015. "Assessing the Effects of Medical Marijuana Laws on Marijuana Use: The Devil is in the Details," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 34(1), pages 7-31, January.
    12. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    13. 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.
    14. Christopher Carpenter & Carlos Dobkin, 2009. "The Effect of Alcohol Consumption on Mortality: Regression Discontinuity Evidence from the Minimum Drinking Age," American Economic Journal: Applied Economics, American Economic Association, vol. 1(1), pages 164-182, January.
    15. Bondurant, Samuel R. & Lindo, Jason M. & Swensen, Isaac D., 2018. "Substance abuse treatment centers and local crime," Journal of Urban Economics, Elsevier, vol. 104(C), pages 124-133.
    16. Jeffrey Clemens, 2012. "The Effect of U.S. Health Insurance Expansions on Medical Innovation," Discussion Papers 11-016, Stanford Institute for Economic Policy Research.
    17. Mingshan Lu & Thomas G. McGuire, 2002. "The Productivity of Outpatient Treatment for Substance Abuse," Journal of Human Resources, University of Wisconsin Press, vol. 37(2), pages 309-335.
    18. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
    19. Swensen, Isaac D., 2015. "Substance-abuse treatment and mortality," Journal of Public Economics, Elsevier, vol. 122(C), pages 13-30.
    20. Frank Sloan & Janet Mitchell & Jerry Cromwell, 1978. "Physician Participation in State Medicaid Programs," NBER Chapters, in: The Economics of Physician and Patient Behavior, pages 211-245, National Bureau of Economic Research, Inc.
    21. Craig L. Garthwaite, 2012. "The Doctor Might See You Now: The Supply Side Effects of Public Health Insurance Expansions," American Economic Journal: Economic Policy, American Economic Association, vol. 4(3), pages 190-215, August.
    22. Anderson, D. Mark, 2010. "Does information matter? The effect of the Meth Project on meth use among youths," Journal of Health Economics, Elsevier, vol. 29(5), pages 732-742, September.
    23. Christopher Carpenter & Carlos Dobkin, 2011. "The Minimum Legal Drinking Age and Public Health," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 133-156, Spring.
    24. Rosalie Liccardo Pacula & David Powell & Paul Heaton & Eric L. Sevigny, 2013. "Assessing the Effects of Medical Marijuana Laws on Marijuana and Alcohol Use: The Devil is in the Details," NBER Working Papers 19302, National Bureau of Economic Research, Inc.
    25. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    26. Robert Kaestner & Kosali Ilayperuma Simon, 2002. "Labor Market Consequences of State Health Insurance Regulation," ILR Review, Cornell University, ILR School, vol. 56(1), pages 136-159, October.
    27. Justin Wolfers, 2006. "Did Unilateral Divorce Laws Raise Divorce Rates? A Reconciliation and New Results," American Economic Review, American Economic Association, vol. 96(5), pages 1802-1820, December.
    28. Hefei Wen & Jason M. Hockenberry & Janet R. Cummings, 2014. "The Effect of Substance Use Disorder Treatment Use on Crime: Evidence from Public Insurance Expansions and Health Insurance Parity Mandates," NBER Working Papers 20537, National Bureau of Economic Research, Inc.
    29. Silverman, Elaine & Skinner, Jonathan, 2004. "Medicare upcoding and hospital ownership," Journal of Health Economics, Elsevier, vol. 23(2), pages 369-389, March.
    30. ., 2014. "Foundations of markets," Chapters, in: How Markets Work and Fail, and What to Make of Them, chapter 2, pages 19-54, Edward Elgar Publishing.
    31. Patrick Kline, 2011. "The Impact of Juvenile Curfew Laws on Arrests of Youth and Adults," American Law and Economics Review, Oxford University Press, vol. 14(1), pages 44-67.
    32. Hamersma Sarah, 2013. "The Effects of Medicaid Earnings Limits on Earnings Growth among Poor Workers," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 13(2), pages 887-919, August.
    33. Thomas Buchmueller & Sarah Miller & Marko Vujicic, 2016. "How Do Providers Respond to Changes in Public Health Insurance Coverage? Evidence from Adult Medicaid Dental Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 8(4), pages 70-102, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Yaa Akosa Antwi & Johanna Catherine Maclean, 2017. "State Health Insurance Mandates and Labor Market Outcomes: New Evidence on Old Questions," NBER Working Papers 23203, National Bureau of Economic Research, Inc.
    2. Johanna Catherine Maclean & Brendan Saloner, 2018. "Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 76-101, January.
    3. Mark McInerney, 2017. "The Affordable Care Act, Public Insurance Expansion and Opioid Overdose Mortality," Working papers 2017-23, University of Connecticut, Department of Economics.
    4. Popovici, Ioana & Maclean, J. Catherine & French, Michael, 2017. "The Effects of Health Insurance Parity Laws for Substance Use Disorder Treatment on Traffic Fatalities: Evidence of Unintended Benefits," IZA Discussion Papers 10746, Institute of Labor Economics (IZA).
    5. Brendan Saloner & Yaa Akosa Antwi & Johanna Catherine Maclean & Benjamin Cook, 2018. "Access to Health Insurance and Utilization of Substance Use Disorder Treatment: Evidence from the Affordable Care Act Dependent Coverage Provision," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 50-75, January.
    6. Sarah Hamersma & Johanna Catherine Maclean, 2018. "Insurance Expansions and Children’s Use of Substance Use Disorder Treatment," NBER Working Papers 24499, National Bureau of Economic Research, Inc.
    7. Ioana Popovici & Johanna Catherine Maclean & Bushra Hijazi & Sharmini Radakrishnan, 2018. "The effect of state laws designed to prevent nonmedical prescription opioid use on overdose deaths and treatment," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 294-305, February.
    8. Ioana Popovici & Johanna Catherine Maclean & Michael T. French, 2017. "Health Insurance and Traffic Fatalities: The Effects of Substance Use Disorder Parity Laws," NBER Working Papers 23388, National Bureau of Economic Research, Inc.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Johanna Catherine Maclean & Brendan Saloner, 2018. "Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 76-101, January.
    2. Hamersma, Sarah & Maclean, Johanna Catherine, 2021. "Do expansions in adolescent access to public insurance affect the decisions of substance use disorder treatment providers?," Journal of Health Economics, Elsevier, vol. 76(C).
    3. Johanna Catherine Maclean & Brendan Saloner, 2019. "The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(2), pages 366-393, March.
    4. Sarah Hamersma & Johanna Catherine Maclean, 2018. "Insurance Expansions and Children’s Use of Substance Use Disorder Treatment," NBER Working Papers 24499, National Bureau of Economic Research, Inc.
    5. Ioana Popovici & Johanna Catherine Maclean & Michael T. French, 2017. "Health Insurance and Traffic Fatalities: The Effects of Substance Use Disorder Parity Laws," NBER Working Papers 23388, National Bureau of Economic Research, Inc.
    6. Popovici, Ioana & Maclean, J. Catherine & French, Michael, 2017. "The Effects of Health Insurance Parity Laws for Substance Use Disorder Treatment on Traffic Fatalities: Evidence of Unintended Benefits," IZA Discussion Papers 10746, Institute of Labor Economics (IZA).
    7. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    8. Brendan Saloner & Yaa Akosa Antwi & Johanna Catherine Maclean & Benjamin Lê Cook, 2015. "Access to health insurance and utilization of public sector substance use treatment: Evidence from the Affordable Care Act dependent coverage provision," DETU Working Papers 1509, Department of Economics, Temple University.
    9. Denis Agniel & Jonathan H. Cantor & Johanna Catherine Maclean & Kosali I. Simon & Erin Taylor, 2023. "Insurance Coverage and Provision of Opioid Treatment: Evidence from Medicare," NBER Working Papers 31884, National Bureau of Economic Research, Inc.
    10. Lauren Hersch Nicholas & Johanna Catherine Maclean, 2019. "The Effect of Medical Marijuana Laws on the Health and Labor Supply of Older Adults: Evidence from the Health and Retirement Study," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(2), pages 455-480, March.
    11. Maclean, Johanna Catherine & Tello-Trillo, Sebastian & Webber, Douglas, 2023. "Losing insurance and psychiatric hospitalizations," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 508-527.
    12. Thomas Buchmueller & Sarah Miller & Marko Vujicic, 2016. "How Do Providers Respond to Changes in Public Health Insurance Coverage? Evidence from Adult Medicaid Dental Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 8(4), pages 70-102, November.
    13. Colleen M. Carey & Sarah Miller & Laura R. Wherry, 2020. "The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare," American Economic Journal: Applied Economics, American Economic Association, vol. 12(4), pages 288-318, October.
    14. Huh, Jason, 2021. "Medicaid and provider supply," Journal of Public Economics, Elsevier, vol. 200(C).
    15. Barron, Kai & Parry, Charles D.H. & Bradshaw, Debbie & Dorrington, Rob & Groenewald, Pam & Laubscher, Ria & Matzopoulos, Richard, 2022. "Alcohol, Violence and Injury-Induced Mortality: Evidence from a Modern-Day Prohibition," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, issue Online Ea, pages 1-44.
    16. Freedman, Seth & Lin, Haizhen & Simon, Kosali, 2015. "Public health insurance expansions and hospital technology adoption," Journal of Public Economics, Elsevier, vol. 121(C), pages 117-131.
    17. Wagner, Kathryn L., 2016. "Shock, but no shift: Hospitals' responses to changes in patient insurance mix," Journal of Health Economics, Elsevier, vol. 49(C), pages 46-58.
    18. Anderson, D. Mark & Rees, Daniel I., 2021. "The Public Health Effects of Legalizing Marijuana," IZA Discussion Papers 14292, Institute of Labor Economics (IZA).
    19. Mark McInerney, 2018. "Opioid Use Disorder Treatment and Mortality: Evidence from Variation in Services Offered," Working papers 2018-21, University of Connecticut, Department of Economics.
    20. Antwi, Yaa Akosa & Maclean, J. Catherine, 2017. "State Health Insurance Mandates and Labor Market Outcomes: New Evidence on Old Questions," IZA Discussion Papers 10578, Institute of Labor Economics (IZA).

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:23094. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.