Volume 53 | Number 1 | February 2018

Abstract List

Sarah A. Friedman M.S.P.H., Amber G. Thalmayer Ph.D., Francisca Azocar Ph.D., Haiyong Xu Ph.D., Jessica M. Harwood M.S., Michael K. Ong M.D., Ph.D., Laura Lambert Johnson B.S., Susan L. Ettner Ph.D.


Did mental health cost‐sharing decrease following implementation of the Mental Health Parity and Addiction Equity Act ()?

Data Source

Specialty mental health copayments, coinsurance, and deductibles, 2008–2013, were obtained from benefits databases for “carve‐in” plans from a national commercial managed behavioral health organization.

Study Design

Bivariate and regression‐adjusted analyses compare the probability of use and (conditional) level of cost‐sharing pre‐ and postparity. An interaction term is added to compare differential levels of pre‐ and postparity cost‐sharing changes for plans that were and were not already at parity pre‐.


Controlling for employer/plan characteristics, is associated with higher intermediate care copayments ($15.9) but lower outpatient ($2.6) copayments among in‐network‐only plans. Among plans with in‐ and out‐of‐network benefits, is associated with lower inpatient ($23.2) and outpatient ($2.5) copayments, but increases in inpatient and intermediate in‐network and out‐of‐network coinsurance (about 1 percentage point). Among the few plans not at parity pre‐, changes in use and level of cost‐sharing associated with were more dramatic.


Mixed evidence that led to more generous mental health benefits may stem from the finding that many plans were already at parity pre‐. Future policy focus in mental health may shift to slowing growth in cost‐sharing for all health services.