title: Effects of a mental health carve-out on use, costs, and payers: a four-year study.
abstract: This study examines the effects of a mental health carve-out on a sample of continuously enrolled employees (N = 1,943) over a four-year time frame (1990-1994). The article presents a health care services utilization model of the effect of the carve-out on outpatient mental health use, cost, and source of payment in the three years post implementation relative to the year prior to the carve-out model. In the first three years of the carve-out, the likelihood of employees seeking mental health care increased in significant part because of the carve-out. For the outpatient mental health services user, the carve-out was not associated with the level of mental health services received. The carve-out was significantly associated over time with a reduction in the patient's and employer's mental health costs. This effect was more pronounced in the second and third years of the carve-out. The article explores the policy implications of these and other findings.
authors.affiliation: School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. KGrazier@umich.edu
authors.forename: K L
authors.initials: KL
authors.lastname: Grazier
authors.forename: L L
authors.initials: LL
authors.lastname: Eselius
authors.forename: T W
authors.initials: TW
authors.lastname: Hu
authors.forename: K K
authors.initials: KK
authors.lastname: Shore
authors.forename: W A
authors.initials: WA
authors.lastname: G'Sell
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D011243:Preferred Provider Organizations / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States