title: Who is paying the price? Loss of health insurance coverage early in psychosis.
abstract: OBJECTIVE
  Discontinuities in health insurance coverage may make it difficult for individuals early in psychosis to receive the services that are critical in determining long-term outcome. This study reports on the rates and continuity of insurance coverage among a cohort of early-psychosis patients enrolled in Specialized Treatment Early in Psychosis (STEP) at the Connecticut Mental Health Center.
  
  
  METHODS
  Insurance status at baseline, six months, and 12 months was collected from 82 participants from a combination of self-reports, clinical chart review, clinician reports, and a database maintained by the state Department of Social Services.
  
  
  RESULTS
  A total of 34 participants did not know whether they had health insurance or did not appear for follow-up assessments at six and 12 months. Among the remaining 48 participants, at baseline 18 had private insurance, 13 had public insurance, and 16 had no insurance. By the 12-month assessment, 13 (72%) privately insured and five (38%) publicly insured participants had lost coverage; less than one-third of the 48 participants (N=14) maintained continuous coverage.
  
  
  CONCLUSIONS
  Specialty services for individuals experiencing early psychosis should address the difficulty of maintaining health insurance coverage during a period of illness in which continuity of care is critical to recovery.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, 300 George St., Suite 901, New Haven, CT 06511, USA. tyler.dodds@aya.yale.edu
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Dodds
authors.forename: Vivek H
authors.initials: VH
authors.lastname: Phutane
authors.forename: B Jamie
authors.initials: BJ
authors.lastname: Stevens
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sernyak
authors.forename: Vinod H
authors.initials: VH
authors.lastname: Srihari
mesh_terms: D003237:Connecticut; D003266:Continuity of Patient Care / Q000191:economics; D017281:Cost of Illness; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics; D008297:Male; D017057:Medically Uninsured; D008605:Mental Health Services / Q000191:economics; D011618:Psychotic Disorders / Q000191:economics* / Q000628:therapy; D055815:Young Adult