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

Author

Listed:
  • Johanna Catherine Maclean

    () (Department of Economics, Temple University)

  • Brendan Saloner

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

Abstract

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.

Suggested Citation

  • Johanna Catherine Maclean & Brendan Saloner, 2015. "Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts," DETU Working Papers 1511, Department of Economics, Temple University.
  • Handle: RePEc:tem:wpaper:1511
    as

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    File URL: http://www.cla.temple.edu/RePEc/documents/DETU_15_11.pdf
    File Function: First version, 2015
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    References listed on IDEAS

    as
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    Cited by:

    1. 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 for the Study of Labor (IZA).
    2. Ioana Popovici & Johanna Catherine Maclean & Michael T. French, 2017. "The Effects of Health Insurance Parity Laws for Substance Use Disorder Treatment on Traffic Fatalities: Evidence of Unintended Benefits," NBER Working Papers 23388, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    healthcare; safety net; provider behavior; substance use disorders; healthcare reform;

    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

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