Was federal parity associated with changes in Out-of-network mental health care use and spending?

Table 1 Unadjusted descriptive characteristics of continuously enrolled (2007–2012) individuals using mental health services in network and out-of-network before and after implementation of federal parity

	Full sample	Enrollees using only in-network services				Enrollees using some or only out-of-network services
	2007–2012	All years 2007–2012	Pre-parity 2007–2009	Post-parity 2010–2012	p-value (pre vs post)	All years 2007–2012	Pre-parity 2007–2009	Post-parity 2010–2012	P-value (pre vs Post)	In-network vs OON 2007–2012
N	698,680	584,719	379,526	437,203		113,961	68,481	66,195
Female (%)	62	62	63	63	0.019	62	63	62	0.004	0.289
Age (%)
18–34	18	18	17	18	<0.001	18	18	18	0.128	<0.001
35–44	31	31	31	31	0.771	32	32	31	0.020
45–54	37	37	37	36	<0.001	36	36	37	0.341
55–64	14	14	14	14	<0.001	14	14	14	0.916
Region (%)
Northeast	11	11	11	11	0.020	14	15	15	0.195	<0.001
Midwest	26	24	24	25	<0.001	36	40	32	<0.001
South	37	38	38	37	<0.001	33	30	34	<0.001
West	26	27	27	27	<0.001	17	15	20	<0.001
Lives in a designated MSA (%)	86	86	86	86	0.360	86	86	87	0.556	0.030
Diagnosis (%):
Psychosis	1.6	1.1	0.9	1.1	<0.001	3.9	2.9	3.9	<0.001	<0.001
Bipolar Disorder	3.7	2.9	3.4	3.1	<0.001	8.3	7.8	8.1	0.021	<0.001
Depression or Anxiety	56.0	55.2	51.4	49.7	<0.001	59.9	56.5	56.2	0.222	<0.001
Attention-deficit hyperactivity disorder	2.9	2.9	2.9	3.4	<0.001	2.7	2.7	2.9	0.060	<0.001
Other	6.2	6.6	5.9	5.2	<0.001	3.7	3.6	3.8	0.098	<0.001
Adjustment disorder	14.2	14.2	13.4	12.9	<0.001	14.6	17.8	13.8	<0.001	<0.001
Residual	15.4	17.1	22.1	24.6	<0.001	6.9	8.7	11.2	<0.001	<0.001

Notes: Age, region and percent living in designated MSA are measured at baseline (2007). We used diagnosis codes to group patients into mutually exclusive hierarchical diagnosis categories. We required patients have the same ICD-9 code listed in the first diagnosis field on at least 2 claims on two dates to have a diagnosis. The diagnostic hierarchy was as follows: schizophrenia, bipolar disorder, depression or anxiety disorders, attention-deficit/hyperactivity disorder, other (including, for example, other affective disorders, other neurotic disorder, eating disorders), adjustment disorder, and a residual category including patients not included in the above

ISSN: 1472-6963