Literature DB >> 32438887

The Role of Behavioral Health Diagnoses in Adverse Selection.

Michelle S Keller1, Haiyong Xu1, Francisca Azocar1, Susan L Ettner1.   

Abstract

OBJECTIVE: Adverse selection in medical insurance is well documented; however, little is known about the role of behavioral health. This study's objective was to examine the probability of being enrolled in the lowest-deductible plan among commercially insured patients, according to psychiatric diagnosis.
METHODS: This cross-sectional study used 2012-2013 benefit design and plan choice data linked to 2011-2012 behavioral health claims for a national sample of individuals (N=116,975) and different family types (couple with at least one dependent, N=59,237; single subscriber with at least one dependent, N=19,066; couple with no dependents, N=40,917) with Optum, UnitedHealth Group "carve-in" plans. Analyses included multiple logistic regressions examining whether the individual (or family) was enrolled in the plan with the lowest deductible as functions of whether individuals (or family members) had any psychiatric diagnosis, the number of psychiatric diagnoses they had, and whether they had individual major psychiatric diagnoses.
RESULTS: For individuals, having any psychiatric diagnosis was associated with an increase of about 10% in the probability of being enrolled in the lowest-deductible plan compared with having no psychiatric diagnosis (44.9% vs. 40.7%, p=0.04). Each additional psychiatric diagnosis increased this probability by three percentage points (p=0.02). A diagnosis of depression was associated with the largest increase.
CONCLUSIONS: When individuals were offered the choice of a health insurance plan, having a prior psychiatric diagnosis (specifically depression) was associated with being enrolled in the lowest-deductible plans. Individuals with depression may anticipate future expenditures and select plans accordingly.

Entities:  

Keywords:  Adverse selection; Behavioral health; Economics; Insurance

Mesh:

Year:  2020        PMID: 32438887      PMCID: PMC7682743          DOI: 10.1176/appi.ps.201900354

Source DB:  PubMed          Journal:  Psychiatr Serv        ISSN: 1075-2730            Impact factor:   3.084


  20 in total

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4.  Regulating a health insurance exchange: implications for individuals with mental illness.

Authors:  Thomas G McGuire; Anna D Sinaiko
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6.  Factors that affect the HMO enrollment decision: a tale of two cities.

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Review 7.  Regression analysis for correlated data.

Authors:  K Y Liang; S L Zeger
Journal:  Annu Rev Public Health       Date:  1993       Impact factor: 21.981

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Authors:  Sean Nicholson; Kate Bundorf; Rebecca M Stein; Daniel Polsky
Journal:  Health Serv Res       Date:  2004-12       Impact factor: 3.402

9.  Risk-Adjustment Simulation: Plans May Have Incentives To Distort Mental Health And Substance Use Coverage.

Authors:  Ellen Montz; Tim Layton; Alisa B Busch; Randall P Ellis; Sherri Rose; Thomas G McGuire
Journal:  Health Aff (Millwood)       Date:  2016-06-01       Impact factor: 6.301

10.  Mental health and choice between managed care and indemnity health insurance.

Authors:  T V Perneger; A F Allaz; J F Etter; A Rougemont
Journal:  Am J Psychiatry       Date:  1995-07       Impact factor: 18.112

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