Implementing parity for mental health and substance use treatment in Medicaid

Marguerite E. Burns, Laura Dague, Brendan Saloner, Kristen Voskuil, Nam Hyo Kim, Natalia Serna Borrero, Kevin Look

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)604-614
Number of pages11
JournalHealth services research
Issue number4
StatePublished - Aug 1 2020


  • Medicaid/economics
  • Medicaid/organization & administration
  • Mental Health Services/economics
  • Mental Health Services/legislation & jurisprudence
  • adult
  • substance-related disorders/economics

ASJC Scopus subject areas

  • Health Policy


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