Increased Service Use Among Children With Autism Spectrum Disorder Associated With Mental Health Parity Law.
Health care services for children with autism spectrum disorder are often expensive and frequently not covered under private health insurance. The 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act was viewed as a possible means of improving access by eliminating differences between behavioral health and medical/surgical benefits. We examined whether the legislation was associated with increased use of and spending on mental health care and functional services for children with autism spectrum disorder compared to the period prior to implementation of the law. We used nationwide health insurance commercial group claims data to examine trends in service use and spending among children with autism spectrum disorder before and after implementation of the law. For such children, implementation was associated with increased use of both mental health and non-mental health services. These increases in use were not associated with higher out-of-pocket spending, which suggests that the law improved financial protection for families.
Elizabeth A. Stuart (estuart@jhu.edu) is associate dean for education, a professor in the Departments of Mental Health, Biostatistics, and Health Policy and Management, and codirector of the Center for Mental Health and Addiction Policy Research, all at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.
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Stuart
Emma E. McGinty is an assistant professor in the Departments of Health Policy and Management and Mental Health and Core Faculty of the Center for Mental Health and Addiction Policy Research, Johns Hopkins Bloomberg School of Public Health.
Emma E
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McGinty
Luther Kalb is a doctoral student in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health.
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Kalb
Haiden A. Huskamp is a professor of health care policy at Harvard Medical School, in Boston, Massachusetts.
Haiden A
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Susan H. Busch is a professor of public health and chair of the Department of Health Policy and Management, Yale University School of Public Health, in New Haven, Connecticut.
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Busch
Teresa B. Gibson is senior director at Truven Health Analytics in Ann Arbor, Michigan.
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Gibson
Howard Goldman is a professor in the Department of Psychiatry, University of Maryland School of Medicine, in Baltimore.
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Goldman
Colleen L. Barry is the Fred and Julie Soper Professor and chair of the Department of Health Policy and Management and codirector of the Center for Mental Health and Addiction Policy Research, Johns Hopkins Bloomberg School of Public Health.
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Barry
D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000191:economics / Q000628:therapy*; D002648:Child; D005260:Female; D005102:Health Expenditures / Q000331:legislation & jurisprudence*; D006801:Humans; D007342:Insurance Benefits; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*
Autism; Interrupted time series; Marketscan; Parity