EFFECT OF MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT (MHPAEA) ON MENTAL HEALTH CARE UTILIZATION
Author(s)
Priyadarsini Dasari, MBBS, MA, MPH1, J. Mike Swint, Ph.D.1, Ruosha Li, Ph.D.2, Paula Cuccaro, Ph.D.1, Robert Morgan, Ph.D.1;
1University of Texas Health Science Center, MPACH, Houston, TX, USA, 2University of Texas Health Science Center, Biostatistics, Houston, TX, USA
1University of Texas Health Science Center, MPACH, Houston, TX, USA, 2University of Texas Health Science Center, Biostatistics, Houston, TX, USA
OBJECTIVES: The Mental Health Parity and Addiction Equity Act (MHPAEA) was implemented in 2010 to provide mental health (MH) benefits equal to medical or surgical benefits. MH service utilization in the United States has evolved substantially over the past couple of decades, coinciding with the differential implementation of MHPAEA across various states. This research aims to understand how these policy changes affected outpatient (OP) visits and inpatient (IP) admissions for MH care and to evaluate long-term trends.
METHODS: Using Medical Expenditure Panel Survey (MEPS) data from 1996-2023, person-level panel data were constructed with annual counts of OP visits and IP admissions. A segmented interrupted time series (ITS) study design with fixed effects was applied to estimate changes in utilization over time. Four time-points were specified: 2000 (when a few states introduced limited MH benefits), 2010 (when MHPAEA was implemented), 2014 (after the final rules for MHPAEA were introduced), and 2017 (when most states included MH benefits with full parity). Models estimated both immediate level changes and changes in annual trends (slopes) following each breakpoint.
RESULTS: For OP visits, slope changes following the 2000, 2010, and 2014 breakpoints were small and not statistically significant, indicating minimal changes in utilization trends during these periods. In contrast, after 2017, the slope increased significantly, corresponding to approximately 0.03 additional OP visits per person per year. For IP admissions, slope changes were similarly negligible for 2000 and 2010, with a modest but borderline significant decline after 2014. A small, yet statistically significant increase was observed after 2017.
CONCLUSIONS: Preliminary results indicate that MH utilization remained largely stable across the first three breakpoints but experienced a structural increase following 2017. The observed increases, which were more pronounced for OP visits, can be attributed to most states including MH benefits with full MH parity.
METHODS: Using Medical Expenditure Panel Survey (MEPS) data from 1996-2023, person-level panel data were constructed with annual counts of OP visits and IP admissions. A segmented interrupted time series (ITS) study design with fixed effects was applied to estimate changes in utilization over time. Four time-points were specified: 2000 (when a few states introduced limited MH benefits), 2010 (when MHPAEA was implemented), 2014 (after the final rules for MHPAEA were introduced), and 2017 (when most states included MH benefits with full parity). Models estimated both immediate level changes and changes in annual trends (slopes) following each breakpoint.
RESULTS: For OP visits, slope changes following the 2000, 2010, and 2014 breakpoints were small and not statistically significant, indicating minimal changes in utilization trends during these periods. In contrast, after 2017, the slope increased significantly, corresponding to approximately 0.03 additional OP visits per person per year. For IP admissions, slope changes were similarly negligible for 2000 and 2010, with a modest but borderline significant decline after 2014. A small, yet statistically significant increase was observed after 2017.
CONCLUSIONS: Preliminary results indicate that MH utilization remained largely stable across the first three breakpoints but experienced a structural increase following 2017. The observed increases, which were more pronounced for OP visits, can be attributed to most states including MH benefits with full MH parity.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HPR138
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity, Insurance Systems & National Health Care, Reimbursement & Access Policy