title: The sensitivity of substance abuse treatment intensity to co-payment levels.
abstract: This study exploits variation in co-payment levels among different contractual arrangements within a regional managed behavioral health care organization to estimate the relationship between co-payment levels for substance use treatment services and the intensity of substance use treatment. The substance use treatment benefits involved a range of co-payment levels across nearly 400 employers during the years 1993 through 1998. Multiple regression techniques were used to estimate the effect of co-payment levels on treatment intensity. The results indicate that co-payment levels had a significant negative effect on outpatient and inpatient substance use treatment. For outpatient treatment the effect on intensity implied a co-payment elasticity of -0.18, implying that moving from a $10 co-payment to a $20 co-payment would result in, for example, a reduction from 5 to 4 outpatient visits per episode. However, the effect was larger for persons with combined alcohol and drug use disorders, as they exhibited a co-payment elasticity of -0.27. For inpatient days, the co-payment elasticity was considerably smaller at -0.017. Given the benefits of maintaining persons with substance use disorders in treatment, employers may have an incentive to take steps to minimize the barriers to treatment.
authors.affiliation: Institute for Policy Research, Northwestern University, 2040 Sheridan Rd, Evanston, IL 60208, USA. a-losasso@northwestern.edu
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Lo Sasso
authors.forename: John S
authors.initials: JS
authors.lastname: Lyons
mesh_terms: D000328:Adult; D002641:Chicago; D015897:Comorbidity; D017047:Cost Sharing / Q000706:statistics & numerical data*; D017281:Cost of Illness; D017050:Episode of Care; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics* / Q000706:statistics & numerical data; D017059:Models, Econometric; D016320:Substance Abuse Treatment Centers / Q000191:economics* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000191:economics* / Q000453:epidemiology / Q000534:rehabilitation*