Use of Outpatient Mental Health Care: Trial of a Prepaid Group Practice Versus Fee-for-service
Rand, Jan 1, 1986 - Social Science - 101 pages
Does a prepaid groupe practice deliver less outpatient mental heath care than fee-for-service when they both serve comparable populations ? to answer this question the authors used data from a randomized controlled trial which assigned families into a prepaid group practice and into fee-for-service insurance plans. The pattern of outpatient mental health care differs for those enrolled at the prepaid group practice and those enrolled in the fee for service. This type provides more expensive and more intensive therapy per user. The enrollees are 50% more likely to see a mental health specialist at leat once over a three years period when they depend of the prepaid group. This difference is due to a higher rate of "turnover" of patients in this type of plan.
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adverse selection analysis ANOVA coinsurance copayment corrected for intrafamily cost-sharing defined by procedure diagnoses assigned Diseases effects equation estimates Family Pay family therapy fee-for fee-for-service coverage fee-for-service participants Fee-for-Service Users Users formally trained mental Free Fee-for-Service plan GHC and fee-for-service GHC Controls GHC Experimental GHC Fee-for-Service Users GHC participants GHC plans GHCE Group Health Cooperative HICDA-2 HMOs and fee-for-service identified by mental imputed expenditure Individual Deductible plan insurance plan Major affective disorders medical providers mental health diagnoses mental health expenses mental health procedure mental health services mental health specialists mental health status mental health visits modal neurosis nonmental health diagnosis number of visits outpatient mental health percent of users probit procedure or diagnosis provider for mental psychiatrists psychotherapy psychotropic drug sample Seattle area services in HMOs standard errors statistically Table trained mental health two-part model users of mental variables visit a mental VISITED BY USERS visits per user