Full access
Articles
Published Online: 29 January 2019

The Effects of Federal Parity on Mental Health Services Use and Spending: Evidence From the Medical Expenditure Panel Survey

Coleman Drake, Ph.D., Susan H. Busch, Ph.D., and Ezra Golberstein, Ph.D. [email protected]Authors Info & Affiliations
Publication: Psychiatric Services
Volume 70, Number 4
https://doi.org/10.1176/appi.ps.201800313
Track CitationsAdd to favorites
PDF/EPUBFormats

Abstract

Objective:

This study evaluated the effects of the federal Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 on the use of outpatient and clinic-based mental health services and spending on those services.

Methods:

Data came from the 2005–2013 Medical Expenditure Panel Survey. The analytic sample included adults ages 26–64 who were continuously enrolled in employer-sponsored insurance for a calendar year (N=66,602 person-year observations). A difference-in-differences study design was used to compare changes in outcomes before and after implementation of the MHPAEA between people whose insurance plan was or was not affected by the law.

Results:

The federal parity law was not significantly associated with changes in the likelihood of using mental health services, the amount of mental health services used, or total or out of-pocket spending for mental health services. The law was marginally significantly associated with a shift toward more use of mental health specialty services rather than primary care services among individuals who used ambulatory mental health care.

Conclusions:

Consistent with other research using different study designs and data, this study found that the MHPAEA had at most small effects on patterns of mental health services use and spending through 2013. Understanding whether these effects were small because most employer-sponsored plans were already parity compliant or because plans were noncompliant with the law has major implications for mental health policy and parity enforcement.

Formats available

You can view the full content in the following formats:

View PDF/EPUBView Full Text

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: XXXX

Psychiatric Services
Volume 70 • Number 4 • April 01, 2019
Pages: 287 - 293
PubMed: 30691381

History

Received: 4 July 2018
Revision received: 3 October 2018
Revision received: 14 November 2018
Accepted: 20 November 2018
Published online: 29 January 2019
Published in print: April 01, 2019

Keywords

  1. Insurance
  2. Financing/funding/reimbursement
  3. Public policy issues

Authors

Details

Coleman Drake, Ph.D.
Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Drake); Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Busch); Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis (Golberstein).
View all articles by this author
Susan H. Busch, Ph.D.
Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Drake); Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Busch); Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis (Golberstein).
View all articles by this author
Ezra Golberstein, Ph.D. [email protected]
Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Drake); Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut (Busch); Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis (Golberstein).
View all articles by this author

Notes

Send correspondence to Dr. Golberstein ([email protected]).
A preliminary version of this research was presented as a poster at the 2017 AcademyHealth Annual Research Meeting, June 25–27, 2017, in New Orleans.

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This work was supported by a grant-in-aid from the Office of the Vice President for Research, University of Minnesota.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard
Tips for downloading citations

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Item saved, go to cart
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share

×

As described within the American Psychiatric Association (APA)'s Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.