TY - JOUR
T1 - Implementing parity for mental health and substance use treatment in Medicaid
AU - Burns, Marguerite E.
AU - Dague, Laura
AU - Saloner, Brendan
AU - Voskuil, Kristen
AU - Kim, Nam Hyo
AU - Serna Borrero, Natalia
AU - Look, Kevin
N1 - Funding Information:
This study was supported through an evaluation contract with the Wisconsin Department of Health Services. We thank the Wisconsin Department of Health Services for the use of data for this analysis. The authors are solely responsible for the content therein, and the agency does not certify the accuracy of the analyses presented. Joint Acknowledgment/Disclosure Statement:
Publisher Copyright:
© Health Research and Educational Trust
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Objective: To estimate the association between the implementation of parity in coverage for mental health and substance use disorder (MHSUD) services within the Medicaid program and MHSUD service use. Data Sources/Study Setting: Wisconsin Medicaid enrollment and claims data from 2013 to 2015. In April 2014, Wisconsin Medicaid transitioned childless adult beneficiaries from coverage with limited MHSUD services to parity-consistent coverage. Preparity, they only had Medicaid coverage for MHSUD visits to psychiatrists and the emergency department, while parent beneficiaries had parity-consistent coverage. Study Design: The study uses a difference-in-differences design to compare outcome changes for childless adult and parent beneficiaries. Data Collection/Extraction Methods: We identified 76, 569 childless adult and parent beneficiaries aged 18-64 who were continuously enrolled for the 2-year study period. Principal Findings: Introducing parity-consistent coverage within Medicaid was associated with increased utilization of Medicaid-reimbursed MHSUD services: outpatient, prescription medication, ED, and inpatient. Increased MHSUD outpatient visits were driven by increased visits to nonpsychiatrists. Conclusions: Parity's effects on MHSUD service use have been studied in the context of private insurance, but its impact among Medicaid beneficiaries has not. Our findings suggest that parity implementation in Medicaid could increase access to effective MHSUD services in a high-need population.
AB - Objective: To estimate the association between the implementation of parity in coverage for mental health and substance use disorder (MHSUD) services within the Medicaid program and MHSUD service use. Data Sources/Study Setting: Wisconsin Medicaid enrollment and claims data from 2013 to 2015. In April 2014, Wisconsin Medicaid transitioned childless adult beneficiaries from coverage with limited MHSUD services to parity-consistent coverage. Preparity, they only had Medicaid coverage for MHSUD visits to psychiatrists and the emergency department, while parent beneficiaries had parity-consistent coverage. Study Design: The study uses a difference-in-differences design to compare outcome changes for childless adult and parent beneficiaries. Data Collection/Extraction Methods: We identified 76, 569 childless adult and parent beneficiaries aged 18-64 who were continuously enrolled for the 2-year study period. Principal Findings: Introducing parity-consistent coverage within Medicaid was associated with increased utilization of Medicaid-reimbursed MHSUD services: outpatient, prescription medication, ED, and inpatient. Increased MHSUD outpatient visits were driven by increased visits to nonpsychiatrists. Conclusions: Parity's effects on MHSUD service use have been studied in the context of private insurance, but its impact among Medicaid beneficiaries has not. Our findings suggest that parity implementation in Medicaid could increase access to effective MHSUD services in a high-need population.
KW - Medicaid/economics
KW - Medicaid/organization & administration
KW - Mental Health Services/economics
KW - Mental Health Services/legislation & jurisprudence
KW - adult
KW - substance-related disorders/economics
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U2 - 10.1111/1475-6773.13309
DO - 10.1111/1475-6773.13309
M3 - Article
C2 - 32578233
AN - SCOPUS:85087146508
SN - 0017-9124
VL - 55
SP - 604
EP - 614
JO - Health services research
JF - Health services research
IS - 4
ER -