Affordability and access of mental health care services have been at the forefront of health care policy for years. In 2008, cost-sharing reductions were phased into Medicare for outpatient mental health services through the Medicare Improvements for Patients and Providers Act (MIPPA). In HealthAffairs, John D. MacArthur Professor of Health Policy and Management Joseph P. Newhouse, PhD, associate professor of health care policy John Hsu, MD, MBA, and colleagues investigate whether the reduction in mental health cost sharing instituted by the MIPPA was associated with positive changes in outpatient mental health visits and psychotropic medication fills.
The study compared mental health services spending for Medicare beneficiaries with individuals with private insurance before and after the implementation of cost-sharing parity. They found that the use of psychotropic medication increased among individuals with Medicare. The greatest increase in psychotropic medication use was seen among patients with probable serious mental illness, as well as Medicare beneficiaries without supplemental coverage. A change in the amount of mental health care visits among Medicare beneficiaries was not detected. This may be because of other non-financial barriers such as transportation, provider availability, and the stigma surrounding receiving care for mental health.
While mental health visits did not increase, the authors suggest that the increased use of psychotropic medication could signify improvement of mental health care access among Medicare beneficiaries, especially among subgroups who were most likely to benefit from this policy change.