IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Log in (now much improved!) to save this paper

Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts

Listed author(s):
  • Johanna Catherine Maclean

    ()

    (Department of Economics, Temple University)

  • Brendan Saloner

    ()

    (Department of Health Policy and Management, Johns Hopkins University)

Major expansions of health insurance coverage provide new revenue opportunities for safety-net providers, but may also create new capacity pressures for these providers. We examine the impact of the 2006 Massachusetts healthcare reform on substance use disorder (SUD) treatment - a type of safety net healthcare – providers' behaviors using a differences-in-differences design. We test whether the reform influenced admissions, daily censuses (the number of clients in treatment on a given day), services offered, and accepted forms of payment. Our findings suggest that Massachusetts providers altered their care practices following the reform. Admissions increased by 17.1% and daily censuses increased by 4.7%. The number of services offered increased by 3.5%, programs for special populations decreased by 24.1%, and use of pharmacotherapies increased by 11.3%. Massachusetts providers increased acceptance of private insurance increased by 2.7%. We find that such providers were less likely to accept self-pay (1.7%) and provide uncompensated care (1.4%). Responsiveness was generally greater for for-profit than nonprofit providers. These findings suggest that, following major healthcare reform, Massachusetts SUD treatment providers absorbed a larger number of individuals seeking treatment, but effects on quality of care were somewhat mixed and individuals without insurance may have experienced difficulty in accessing care.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://www.cla.temple.edu/RePEc/documents/DETU_15_11.pdf
File Function: First version, 2015
Download Restriction: no

Paper provided by Department of Economics, Temple University in its series DETU Working Papers with number 1511.

as
in new window

Length:
Date of creation: Sep 2015
Handle: RePEc:tem:wpaper:1511
Contact details of provider: Postal:
Ritter Annex 877, Philadelphia, PA 19122

Phone: 215.204.8880
Fax: 215.204.8173
Web page: http://www.cla.temple.edu/economics/

More information through EDIRC

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as
in new window


  1. 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, 02.
  2. Jonathan Gruber, 2011. "Massachusetts points the way to successful health care reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 30(1), pages 184-192, December.
  3. 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.
  4. Swensen, Isaac D., 2015. "Substance-abuse treatment and mortality," Journal of Public Economics, Elsevier, vol. 122(C), pages 13-30.
  5. Silverman, Elaine & Skinner, Jonathan, 2004. "Medicare upcoding and hospital ownership," Journal of Health Economics, Elsevier, vol. 23(2), pages 369-389, March.
  6. Lakdawalla, Darius & Philipson, Tomas, 2006. "The nonprofit sector and industry performance," Journal of Public Economics, Elsevier, vol. 90(8-9), pages 1681-1698, September.
  7. Johanna Catherine Maclean & Ioana Popovici & Elisheva Stern, 2015. "Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers," DETU Working Papers 1510, Department of Economics, Temple University.
  8. 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.
  9. Miller, Sarah, 2012. "The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform," Journal of Public Economics, Elsevier, vol. 96(11), pages 893-908.
  10. 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.
  11. María E. Dávalos & Hai Fang & Michael T. French, 2012. "Easing The Pain Of An Economic Downturn: Macroeconomic Conditions And Excessive Alcohol Consumption," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1318-1335, November.
  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. 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, pages 539-557.
  14. 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.
  15. 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.
  16. Jonathan Gruber, 2008. "Massachusetts Health Care Reform: The View From One Year Out," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 11(1), pages 51-63, March.
  17. Charles J. Courtemanche & Daniela Zapata, 2014. "Does Universal Coverage Improve Health? The Massachusetts Experience," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 33(1), pages 36-69, 01.
  18. Sharon K. Long & Karen Stockley & Alshadye Yemane, 2009. "Another Look at the Impacts of Health Reform in Massachusetts: Evidence Using New Data and a Stronger Model," American Economic Review, American Economic Association, vol. 99(2), pages 508-511, May.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:tem:wpaper:1511. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dimitrios Diamantaras)

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 references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.

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

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.