Effect of eliminating behavioral health benefits for selected medicaid enrollees

Kenneth (John) McConnell, Neal T. Wallace, Charles A. Gallia, Jeanene A. Smith

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective. To determine the extent to which the elimination of behavioral health benefits for selected beneficiaries of Oregon's Medicaid program affected general medical expenditures among enrollees using outpatient mental health and substance abuse treatment services. Data Source/Study Setting. Twelve months of claims before and 12 months following a 2003 policy change, which included the elimination of the behavioral health benefit for selected Oregon Medicaid enrollees. Study Design. We use a difference-in-differences approach to estimate the change in general medical expenditures following the 2003 policy change. We compare two methodological approaches: regression with propensity score weighting; and one-to-one covariate matching. Principal Findings. Enrollees who had accessed the substance abuse treatment benefit demonstrated substantial and statistically significant increases in expenditures. Individuals who accessed the outpatient mental health benefit demonstrated a decrease or no change in expenditures, depending on model specification. Conclusions. Elimination of the substance abuse benefit led to increased medical expenditures, although this offset was still smaller than the total cost of the benefit. In contrast, individuals who accessed the outpatient mental health benefit did not exhibit a similar increase, although these individuals did not include a portion of the Medicaid population with severe mental illnesses.

Original languageEnglish (US)
Pages (from-to)1348-1365
Number of pages18
JournalHealth Services Research
Volume43
Issue number4
DOIs
StatePublished - Aug 2008

Fingerprint

Medicaid
Insurance Benefits
Health Expenditures
expenditures
substance abuse
Substance-Related Disorders
health
Mental Health
Outpatients
mental health
Propensity Score
Information Storage and Retrieval
weighting
mental illness
Cost-Benefit Analysis
regression
Therapeutics
costs
Population

Keywords

  • Benefit design
  • Medicaid
  • Mental health
  • Substance abuse

ASJC Scopus subject areas

  • Nursing(all)
  • Health(social science)
  • Health Professions(all)
  • Health Policy

Cite this

Effect of eliminating behavioral health benefits for selected medicaid enrollees. / McConnell, Kenneth (John); Wallace, Neal T.; Gallia, Charles A.; Smith, Jeanene A.

In: Health Services Research, Vol. 43, No. 4, 08.2008, p. 1348-1365.

Research output: Contribution to journalArticle

McConnell, Kenneth (John) ; Wallace, Neal T. ; Gallia, Charles A. ; Smith, Jeanene A. / Effect of eliminating behavioral health benefits for selected medicaid enrollees. In: Health Services Research. 2008 ; Vol. 43, No. 4. pp. 1348-1365.
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