Expanded Health Insurance: Hospital Services Use by Young Adults with Behavioral Diagnoses

MedicalResearch.com Interview with:
Ellen R. Meara Associate Professor of The Dartmouth Institute Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College Ellen R. Meara
Associate Professor of The Dartmouth Institute
Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College


MedicalResearch.com: What are the main findings of this study?

Answer: When insurance coverage for young adults rose by over 15 percentage points following Massachusetts’ 2006 health reform, use of inpatient care for mental illness and substance use disorders fell and emergency department visits for these conditions grew more slowly for 19 to 25 year olds in Massachusetts relative to other states. Also, their care was much more likely to be paid for by private or public insurance insurers.


MedicalResearch.com: Where any of the findings surprising?

Answer: Because treatment for mental illness and substance use disorders has been more responsive to the price patients face, compared with treatment of physical conditions, some policymakers have feared that expanding insurance coverage would lead to rapid growth in spending on treatment of mental illness and substance use disorders, especially in expensive hospital settings. We found that, in Massachusetts, a group with high need for treatment of mental illness and substance abuse, young adults, did not increase use of hospital care compared with other states after 2006.

MedicalResearch.com: What should patients and providers take take away from your study?

Answer: Takeaway for clinicians and patients – with expanded insurance coverage, when young adults do need hospital based care, the financial burden to patients and providers is lower.

MedicalResearch.com: What future research do you recommend as a result of your report?

Answer: We need better data on care in outpatient settings, since we cannot distinguish whether lower use of hospital care in Massachusetts reflects access to effective outpatient care, or some other trend that limited use of hospital care after health reform

Citation:
Use of Hospital-Based Services Among Young Adults
With Behavioral Health Diagnoses Before and After Health
Insurance Expansions

Ellen R. Meara, Dartmouth College, Ezra Golberstein, University of Minnesota, Rebecca Zaha, The Dartmouth Institute for Health Policy and Clinical Practice, Shelly F. Greenfield, McLean Hospital, William R. Beardslee, Harvard University and Susan H. Busch, Yale University

Presented at Association for Public Policy Analysis and Management

Fall 2013