TY - JOUR
T1 - Federal parity and spending for mental illness
AU - Kennedy-Hendricks, Alene
AU - Epstein, Andrew J.
AU - Stuart, Elizabeth A.
AU - Haffajee, Rebecca L.
AU - McGinty, Emma E.
AU - Busch, Alisa B.
AU - Huskamp, Haiden A.
AU - Barry, Colleen L.
N1 - Funding Information:
FUNDING: Supported by National Institute of Mental Health grant MH093414. Funded by the National Institutes of Health (NIH).
Publisher Copyright:
Copyright © 2018 by the American Academy of Pediatrics.
PY - 2018/8
Y1 - 2018/8
N2 - BACKGROUND: Families of children with mental health conditions face heavy economic burdens. One of the objectives of the Mental Health Parity and Addiction Equity Act (MHPAEA) is to reduce the financial burden for those with intensive mental health service needs. Few researchers to date have examined MHPAEA’s effects on children with mental health conditions and those with particularly high mental health expenditures. METHODS: A difference-in-differences approach was used to compare commercially insured children ages 3 to 18 years (in 2008) who were continuously enrolled in plans newly subject to parity under MHPAEA to children continuously enrolled in plans never subject to parity. Data included inpatient, outpatient, and pharmaceutical claims for 2008–2012 from 3 national commercial insurers. We examined annual mental health service use and spending outcomes. RESULTS: Among children with mental health conditions who were enrolled in plans subject to parity, parity was associated with $140 (95% confidence interval: −$196 to −$84) lower average annual out-of-pocket (OOP) mental health spending than expected given changes in the comparison group. Among children who were ≥85th percentile in total mental health spending, parity was associated with $234 (−$391 to −$76) lower average annual OOP mental health spending. CONCLUSIONS: MHPAEA was associated with increased financial protection on average for children with mental health conditions and among those at the higher end of the spending distribution. However, estimated reductions in OOP spending were likely too modest to have substantially reduced financial burden on families of children with particularly high mental health expenditures.
AB - BACKGROUND: Families of children with mental health conditions face heavy economic burdens. One of the objectives of the Mental Health Parity and Addiction Equity Act (MHPAEA) is to reduce the financial burden for those with intensive mental health service needs. Few researchers to date have examined MHPAEA’s effects on children with mental health conditions and those with particularly high mental health expenditures. METHODS: A difference-in-differences approach was used to compare commercially insured children ages 3 to 18 years (in 2008) who were continuously enrolled in plans newly subject to parity under MHPAEA to children continuously enrolled in plans never subject to parity. Data included inpatient, outpatient, and pharmaceutical claims for 2008–2012 from 3 national commercial insurers. We examined annual mental health service use and spending outcomes. RESULTS: Among children with mental health conditions who were enrolled in plans subject to parity, parity was associated with $140 (95% confidence interval: −$196 to −$84) lower average annual out-of-pocket (OOP) mental health spending than expected given changes in the comparison group. Among children who were ≥85th percentile in total mental health spending, parity was associated with $234 (−$391 to −$76) lower average annual OOP mental health spending. CONCLUSIONS: MHPAEA was associated with increased financial protection on average for children with mental health conditions and among those at the higher end of the spending distribution. However, estimated reductions in OOP spending were likely too modest to have substantially reduced financial burden on families of children with particularly high mental health expenditures.
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U2 - 10.1542/peds.2017-2618
DO - 10.1542/peds.2017-2618
M3 - Article
C2 - 30037977
AN - SCOPUS:85051062574
VL - 142
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 2
M1 - e20172618
ER -