The Effect of Parity on Expenditures for Individuals with Severe Mental Illness
Article first published online: 5 APR 2013
© Health Research and Educational Trust
Health Services Research
Volume 48, Issue 5, pages 1634–1652, October 2013
How to Cite
McConnell, K. J. (2013), The Effect of Parity on Expenditures for Individuals with Severe Mental Illness. Health Services Research, 48: 1634–1652. doi: 10.1111/1475-6773.12058
- Issue published online: 16 SEP 2013
- Article first published online: 5 APR 2013
- National Institute on Drug Abuse. Grant Number: RO1DA024024
- Health economics;
- health care costs;
- health care financing/insurance/premiums;
- mental health;
- substance abuse: alcohol dependency/tobacco
To determine whether comprehensive behavioral health parity leads to changes in expenditures for individuals with severe mental illness (SMI), who are likely to be in greatest need for services that could be outside of health plans' traditional limitations on behavioral health care.
Data Sources/Study Setting
We studied the effects of a comprehensive parity law enacted by Oregon in 2007. Using claims data, we compared expenditures for individuals in four Oregon commercial plans from 2005 through 2008 to a group of commercially insured individuals in Oregon who were exempt from parity.
We used difference-in-differences and difference-in-difference-in-differences analyses to estimate changes in spending, and quantile regression methods to assess changes in the distribution of expenditures associated with parity.
Among 2,195 individuals with SMI, parity was associated with increased expenditures for behavioral health services of $333 (95 percent CI $67, $615), without corresponding increases in out-of-pocket spending. The increase in expenditures was primarily attributable to shifts in the right tail of the distribution.
Oregon's parity law led to higher average expenditures for individuals with SMI. Parity may allow individuals with high mental health needs to receive services that may have been limited without parity regulations.