title: Insurance expenditures on bipolar disorder: clinical and parity implications.
abstract: OBJECTIVE
  This study assessed treatment rates and expenditures for behavioral health care by employers and behavioral health care patients in a large national database of employer-sponsored health insurance claims.
  
  
  METHODS
  Insurance claims from 1996 from approximately 1.66 million individuals were examined. Average annual charges per person and payments for behavioral health care were calculated along with patient out-of-pocket expenses and inpatient hospital admission rates. Behavioral health care expenditures for bipolar disorder were compared to expenditures for other behavioral health care diagnoses in these same insurance plans.
  
  
  RESULTS
  A total of 7.5% of all covered individuals filed a behavioral health care claim. Of those, 3.0% were identified as having bipolar disorder, but they accounted for 12.4% of total plan expenditures. Patients with bipolar disorder incurred annual out-of-pocket expenses of $568, more than double the $232 out-of-pocket expenses incurred by all claimants. The inpatient hospital admission rate for patients with bipolar disorder was also higher (39.1%) compared to 4.5% for all other behavioral health care claimants. Furthermore, annual insurance payments were higher for covered medical services for individuals with bipolar disorder than for patients with other behavioral health care diagnoses.
  
  
  CONCLUSIONS
  Bipolar disorder is the most expensive behavioral health care diagnosis, both for patients with bipolar disorder and for their insurance plans. For every behavioral health care dollar spent on outpatient care for patients with bipolar disorder, $1.80 is spent on inpatient care, suggesting that better prevention management could decrease the financial burden of bipolar disorder.
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. peele@pitt.edu
authors.forename: Pamela B
authors.initials: PB
authors.lastname: Peele
authors.forename: Ying
authors.initials: Y
authors.lastname: Xu
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D001714:Bipolar Disorder / Q000191:economics* / Q000517:prevention & control / Q000628:therapy; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data; D007358:Insurance, Psychiatric / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000628:therapy