Table 5.
Nonquantitative Treatment Limits for Mental Health (MH) and Substance Use Disorder (SUD) Services among TOPS Carve‐in Employers: Regression‐adjusted Changes Associated with Paritya—Changes in Probability of Using Different Penalty Types and Changes in the Mean Penalty Amounts
| Pre/Postparity Difference in Probability of Using Given Penalty | Pre/Postparity Difference in Mean Penalty, among Plans Requiring the Penalty | Pre/Postparity Difference in Mean Penalty Amount, among All Plans | ||||
|---|---|---|---|---|---|---|
| Estimate | p‐value | Estimate | p‐value | Estimate | p‐value | |
| In‐network | ||||||
| Additional patient coinsurance (percentage) | ||||||
| Inpatient MH | −0.03 | .10 | −22.58 | <.01 | −17.37 | <.01 |
| Intermediate MH | 0.00 | .98 | −23.13 | <.01 | −15.69 | <.01 |
| Outpatient MH | 0.31 | <.01 | −22.53 | <.01 | 9.65 | <.01 |
| Inpatient SUD | −0.03 | .09 | −22.63 | <.01 | −17.47 | <.01 |
| Intermediate SUD | 0.00 | 1.00 | −23.25 | <.01 | −15.73 | <.01 |
| Outpatient SUD | 0.31 | <.01 | −22.58 | <.01 | 9.64 | <.01 |
| Additional patient copayment ($) | ||||||
| Inpatient MH/SUD | 0.13 | <.01 | .80 | .96 | 56.42 | <.01 |
| Intermediate MH/SUD | 0.17 | <.01 | 3.27 | .83 | 71.97 | <.01 |
| Outpatient MH/SUD | 0.13 | <.01 | −80.62 | .02 | 54.62 | <.01 |
| Out‐of‐networkb | ||||||
| Additional patient coinsurance (percentage) | ||||||
| Inpatient MH | −0.18 | <.01 | −29.96 | <.01 | −17.29 | <.01 |
| Intermediate MH | −0.16 | <.01 | −30.07 | <.01 | −16.25 | <.01 |
| Outpatient MH | 0.06 | <.01 | −25.89 | <.01 | −1.07 | .22 |
| Inpatient SUDc | ||||||
| Intermediate SUD | −0.16 | <.01 | −30.07 | <.01 | −16.27 | <.01 |
| Outpatient SUD | 0.06 | <.01 | −25.89 | <.01 | −1.07 | .22 |
| Additional patient copayment ($) | ||||||
| Inpatient MH/SUD | 0.16 | <.01 | −9.15 | .53 | 61.86 | <.01 |
| Intermediate MH/SUD | 0.20 | <.01 | −2.48 | .87 | 80.35 | <.01 |
| Outpatient MH/SUD | 0.16 | <.01 | −106.67 | <.01 | 66.27 | <.01 |
Preparity (2008–2010; N = 6360 plan‐years), postparity (2011–2013; N = 6,187 plan‐years). Regressions control for employer size, region, and industry, plan type, and network status (for INN services only). Standard errors are adjusted for intraclass correlation at the employer group level.
The unit of observation is the plan‐year. Analysis excludes plan‐years that do not cover a given service and plan‐years with missing data for a particular penalty type.
Among plan‐years with out‐of‐network benefits: preparity N = 4,109 plan‐years; postparity N = 4,445 plan‐years.
No statistics are available; there were no plans with the given penalty in the post‐parity period.