Volume 55 | Number 6 | December 2020

Abstract List

Sarah Friedman Ph.D., Haiyong Xu Ph.D., Francisca Azocar Ph.D., Susan L. Ettner Ph.D.


To examine changes in carve‐out financial requirements (copayments, coinsurance, use of deductibles, and out‐of‐pocket maxima) following the Mental Health Parity and Addiction Equity Act (MHPAEA).

Data Source/Study Setting

Specialty mental health benefit design information for employer‐sponsored carve‐out plans from a national managed behavioral health organization's claims processing engine (2008‐2013).

Study Design

This pre‐post study reports linear and logistic regression as the main analysis.

Data Collection/Extraction Methods


Principal Findings

Copayments for in‐network emergency room (−$44.9, 95% CI: −78.3, −11.5; preparity mean: $56.2), outpatient services (eg, individual psychotherapy: −$7.4, 95% CI: −10.5, −4.2; preparity mean: $17.8), and out‐of‐network coinsurance for emergency room (−11 percentage points, 95% CI: −16.7, −5.4; preparity mean: 38.8 percent) and outpatient (eg, individual psychotherapy: −5.8 percentage points, 95% CI: −10.0, −1.6; preparity mean 41.0 percent) decreased. Probability of family OOP maxima use (29 percentage points, 95% CI: 19.3, 38.6; preparity mean: 36 percent) increased. In‐network outpatient coinsurance increased (eg, individual psychotherapy: 4.5 percentage points, 95% CI: 1.1, 7.9; preparity mean: 2.7 percent), as did probability of use of family deductibles (15 percentage points, 95% CI: 6.1, 23.3; preparity mean: 38 percent).


MHPAEA was associated with increased generosity in most financial requirements observed here. However, increased use of deductibles may have reduced generosity for some patients.