Table 1.
Demographics and spending/service use at the member-month level.
| Table 1a: Demographics and
employer, plan, and provider information | ||
|---|---|---|
| Total number of employers | 393 | |
| Total number of plans | 6,587 | |
| Total number of members | 5,987,776 | |
| Total number of member-months | 179,506,951 | |
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| n | % | |
|
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||
| Age group | ||
| 27–34 years | 35,742,653 | 19.9 |
| 35–44 | 49,634,679 | 27.7 |
| 45–54 | 52,758,152 | 29.4 |
| 55–64 | 41,371,467 | 23.0 |
| Male (vs. female) | 87,980,696 | 49.0 |
| Census Division | ||
| Northeast: New England | 7,272,335 | 4.1 |
| Northeast: Middle Atlantic | 20,034,873 | 11.2 |
| Midwest: East North Central | 28,083,675 | 15.6 |
| Midwest: West North Central | 17,624,910 | 9.8 |
| South: South Atlantic | 34,657,012 | 19.3 |
| South: East South Central | 8,603,236 | 4.8 |
| South: West South Central | 28,129,871 | 15.7 |
| West: Mountain | 17,226,012 | 9.6 |
| West: Pacific | 17,875,027 | 10.0 |
| Primary insured person (vs. dependent) | 120,533,776 | 67.2 |
| Employer group size | ||
| >40K enrolled employees | 44,609,973 | 24.9 |
| >10K & ≤40K | 75,906,647 | 42.3 |
| 5,000–10,000 | 30,849,945 | 17.2 |
| <5,000 | 28,140,386 | 15.7 |
| Plan type is EPO, POS, or HMO (vs. PPO, MIN, HDHP)1 | 163,955,965 | 91.9 |
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| Number of providers per 1000 members, for a given state & year, by provider type: | Mean | SD |
|
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||
| MD (doctor of medicine) | 0.8 | 0.7 |
| MSW (master of social work) | 3.1 | 3.7 |
| PHD (doctor of philosophy) | 1.1 | 1.1 |
| RN (registered nurse) | 0.2 | 0.3 |
| Non-independent licensed | 0.2 | 2.3 |
| Table 1b: Member-months with
any spending/service use, and diagnostic distribution | ||
|---|---|---|
| n | % | |
|
|
||
| Any spending/service use | 4,251,730 | 2.4 |
| Among member-months with any spending/service use: | ||
| Any adjustment disorder | 1,081,747 | 25.4 |
| Any post-traumatic stress disorder | 167,027 | 3.9 |
| Any generalized anxiety | 817,409 | 19.2 |
| Any obsessive-compulsive disorder | 80,100 | 1.9 |
| Any panic disorder | 180,569 | 4.2 |
| Any phobia | 37,360 | 0.9 |
| Any cognitive disorder | 16,386 | 0.4 |
| Any bipolar disorder | 370,660 | 8.7 |
| Any depressive disorder | 1,863,744 | 43.8 |
| Any personality disorder | 33,435 | 0.8 |
| Any psychotic disorder | 50,627 | 1.2 |
| Any alcohol use disorder | 139,158 | 3.3 |
| Any drug use disorder | 81,333 | 1.9 |
| Any other psychiatric disorder | 222,506 | 5.2 |
| Table 1c: Spending and service
use, by expenditure/utilization type | ||
|---|---|---|
| Any spending/service use | n | % |
|
|
||
| Total Expenditures | 4,246,461 | 2.37 |
| Plan Expenditures | 3,581,143 | 2.00 |
| Patient Out-Of-Pocket Expenditures | 3,849,122 | 2.14 |
| Outpatient Assessment/Diagnostic Evaluation | 502,497 | 0.28 |
| Outpatient Medication Management | 1,476,538 | 0.82 |
| Outpatient Individual Psychotherapy | 2,469,851 | 1.38 |
| Outpatient Family Psychotherapy | 195,433 | 0.11 |
| Structured Outpatient Care | 56,120 | 0.03 |
| Day Treatment Care | 21,011 | 0.01 |
| Residential Care | 12,948 | 0.01 |
| Inpatient Care | 50,030 | 0.03 |
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| Level of spending/service use, among users | Mean | SD |
|
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| Total Expenditures ($) | 345.4 | 1,453.0 |
| Plan Expenditures ($) | 300.6 | 1,449.0 |
| Patient Out-Of-Pocket Expenditures ($) | 101.6 | 252.0 |
| Outpatient Assessment/Diagnostic Evaluation (visits) | 1.3 | 1.1 |
| Outpatient Medication Management (visits) | 1.3 | 0.9 |
| Outpatient Individual Psychotherapy (visits) | 2.3 | 1.6 |
| Outpatient Family Psychotherapy (visits) | 1.8 | 1.2 |
| Structured Outpatient (days) | 6.2 | 5.5 |
| Day Treatment (days) | 6.3 | 5.9 |
| Residential (days) | 9.1 | 8.4 |
| Inpatient (days) | 5.9 | 5.1 |
Note:
1
“EPO”: exclusive provider organization; “POS”: point of service; “HMO”: health maintenance organization; “PPO”: preferred provider organization; “MIN”: managed indemnity; “HDHP”: high-deductible health plan.