Suchergebnisse

It is increasingly recognized that sugar-sweetened beverage consumption contributes to childhood obesity. Most states have adopted laws that regulate the availability of sugar-sweetened beverages in school settings. However, such policies have encountered resistance from consumer and parent groups, as well as the beverage industry.

BACKGROUND: Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES: To determine the association between federal parity and changes in mental health care utilization and spending, particularly among high utilizers. RESEARCH DESIGN: Difference-in-differences analyses compared changes before and after exposure to federal parity vs. a comparison group SUBJECTS: Commercially-insured enrollees aged 18–64 with a mental health disorder drawn from 24 states where self-insured employers were newly subject to federal parity in 2010 (exposure group), but small employers were exempt before-and-after parity (comparison group). 11,226 exposure group members were propensity score matched (1:1) to comparison group members, all of whom were continuously enrolled from 1 year pre- to 1–2 years post-policy. MEASURES: Mental health outpatient visits, out-of-pocket spending for these visits, emergency department visits, and hospitalizations. RESULTS: Relative to comparison group members, mean out-of-pocket spending per outpatient mental health visit declined among exposure enrollees by $0.74(1.40,0.07) and $2.03(3.17,0.89) in years 1 and 2 after the policy, respectively. Corresponding annual mental health visits increased by 0.31(0.12,0.51) and 0.59(0.37,0.81) per enrollee. Difference-in-difference changes were larger for the highest baseline quartile mental health care utilizers (Year 2: 0.76 visits per enrollee [0.14,1.38]; relative increase 10.07%) and spenders (Year 2: $−2.28 [−3.76,−0.79]; relative reduction 5.91%) There were no significant difference-in-differences changes in emergency department visits or hospitalizations. CONCLUSIONS: In 24 states, commercially-insured high utilizers of mental health services experienced modest increases in outpatient mental health visits 2 years post-parity.