Translating behavioral health services research into benefits policy

Med Care Res Rev. 2000:57 Suppl 2:53-71. doi: 10.1177/1077558700057002S04.

Abstract

This article uses a 4-pronged statistical approach to examine the impact of a mental health carve-out at a major employer. To examine net financial impact of the carve-out, the authors perform a pre-post, multivariate regression analysis of changes in costs. Using a random-effects model, the authors explore the ultimate financial impact of the carve-out for patients and for the firm. Using a multinomial logistic regression, they examine differing program effects by intensity of use. A fixed-effects negative binomial regression models the episodic nature of outpatient care, controlling for patient-specific unobserved characteristics that influence health care utilization. The carve-out slightly reduced overall mental health costs and utilization while expanding entry-level access to routine services. At the same time, the specific carve-out shifted financial burdens from the firm onto high-utilization patients. Therefore, this carve-out appears poorly suited to the care of individuals experiencing severe and debilitating psychiatric disorders.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • California
  • Diffusion of Innovation*
  • Female
  • Health Benefit Plans, Employee / organization & administration*
  • Health Care Costs / statistics & numerical data
  • Health Policy
  • Health Services Accessibility / organization & administration
  • Health Services Research / organization & administration*
  • Humans
  • Insurance, Psychiatric*
  • Logistic Models
  • Male
  • Mental Health Services / economics*
  • Middle Aged
  • Multivariate Analysis
  • Preferred Provider Organizations / organization & administration*
  • Program Evaluation