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).
This pre‐post study reports linear and logistic regression as the main analysis.
Data Collection/Extraction Methods
NA.
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.
