Expanded mental health benefits and outpatient depression treatment intensity.
BACKGROUND
The justification for higher cost-sharing for behavioral health treatment is its greater price sensitivity relative to general healthcare treatment. Despite this, recent policy efforts have focused on improving access to behavioral health treatment.


OBJECTIVE
We measured the effects on outpatient treatment of depression of a change in mental health benefits for employees of a large U.S.-based corporation.


METHODS
The benefit change involved 3 major elements: reduced copayments for mental health treatment, the implementation of a selective contracting network, and an effort to destigmatize mental illness. Claims data and a difference-in-differences methodology were used to examine how the benefit change affected outpatient treatment of depression.


METHODS
Subjects consisted of 214,517 employee-years of data for individuals who were continuously enrolled for at least 1 full year at the intervention company and 96,365 employee-years in the control group.


METHODS
We measured initiation into treatment of depression and the number of outpatient therapy visits.


RESULTS
The benefit change was associated with a 26% increase in the probability of initiating depression treatment. Conditional on initiating treatment, patients in the intervention company received 1.2 additional (P < 0.001) outpatient mental health treatment visits relative to the control group.


CONCLUSIONS
Our results suggest that the overall effect of the company's benefit change was to significantly increase the number of outpatient visits per episode of treatment conditional on treatment initiation.
Lo Sasso
Anthony T
AT
Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60612, USA. losasso@uic.edu
Lindrooth
Richard C
RC
Lurie
Ithai Z
IZ
Lyons
John S
JS
D000328:Adult; D016022:Case-Control Studies; D017047:Cost Sharing; D003863:Depression / Q000191:economics* / Q000628:therapy*; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics* / Q000592:standards; D017048:Health Care Costs; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data; D007358:Insurance, Psychiatric / Q000191:economics* / Q000592:standards; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D009786:Occupational Health Services / Q000191:economics* / Q000706:statistics & numerical data; D009819:Office Visits / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D017132:Workplace / Q000191:economics