Abstract

http://ssrn.com/abstract=1460935
 


 



Fragmentation in Mental Health Benefits and Services: A Preliminary Examination into Consumption and Outcomes


Barak D. Richman


Duke University - School of Law

Frank A. Sloan


Duke University - Center for Health Policy, Law and Management; Duke University, Fuqua School of Business-Economics Group; Duke University - Department of Economics; National Bureau of Economic Research (NBER)

Dan Grossman


Duke University Medical Center

August 2, 2012

OUR FRAGMENTED HEALTH SYSTEM: CAUSES AND SOLUTIONS, Barak Richman, Daniel Grossman, and Frank Sloan (Einer Elhauge, ed.), Oxford University Press, 2010

Abstract:     
In this chapter, we examine consumption patterns and health outcomes within a health insurance system in which mental health benefits are administered under a carved-out insurance plan. Using a comprehensive dataset of health claims, including insurance claims for both mental and physical health services, we examine both heterogeneity of consumption and variation in outcomes. Consumption variation addresses the regularly overlooked question of how equal insurance and access does not translate into equitable consumption. Outcomes variation yields insights into the potential harms of disparate consumption and of uncoordinated care. We find that even when insurance and access are held constant, consumption of mental health services varies dramatically across race and class. We are unable, however, to find any evidence that higher levels of consumption correspond with improved health when health status is controlled. We also find some evidence of the costs of fragmentation, such as uncoordinated care, low adherence rates, and variation in sources of care. These findings have important implications for both the delivery of health services and the administration of health insurance benefits.

Number of Pages in PDF File: 22

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Date posted: August 26, 2009 ; Last revised: August 4, 2012

Suggested Citation

Richman, Barak D. and Sloan, Frank A. and Grossman, Dan, Fragmentation in Mental Health Benefits and Services: A Preliminary Examination into Consumption and Outcomes (August 2, 2012). OUR FRAGMENTED HEALTH SYSTEM: CAUSES AND SOLUTIONS, Barak Richman, Daniel Grossman, and Frank Sloan (Einer Elhauge, ed.), Oxford University Press, 2010. Available at SSRN: http://ssrn.com/abstract=1460935 or http://dx.doi.org/10.2139/ssrn.1460935

Contact Information

Barak D. Richman (Contact Author)
Duke University - School of Law ( email )
Box 90360
Duke School of Law
Durham, NC 27708
United States
919-613-7244 (Phone)
919-613-7231 (Fax)
Frank A. Sloan
Duke University - Center for Health Policy, Law and Management ( email )
Box 90253
Durham, NC 27708
United States
919-684-8047 (Phone)
919-684-6246 (Fax)
Duke University, Fuqua School of Business-Economics Group ( email )
Box 90097
Durham, NC 27708-0097
United States
Duke University - Department of Economics ( email )
Durham, NC 27708-0204
United States
National Bureau of Economic Research (NBER)
1050 Massachusetts Avenue
Cambridge, MA 02138
United States
Dan Grossman
Duke University Medical Center ( email )
Durham, NC 27715
United States
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