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Insurance Financing Increased For Mental Health Conditions But Not For Substance Use Disorders, 1986-2014.

Tami L Mark1, Tracy Yee2, Katharine R Levit3

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US healthcare spending shows increased insurance for mental health care, rising to 68% by 2014. However, funding for substance use disorder treatment remained stagnant, with minimal increases in treatment access.

Keywords:
Health EconomicsHealth ReformHealth SpendingMedicaidMental Health/Substance Abuse

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Area of Science:

  • Health Economics
  • Public Health Policy
  • Mental Health Services Research

Background:

  • Previous estimates of US healthcare spending on mental health and substance use disorders (SUDs) required updating.
  • Understanding financing trends is crucial for assessing healthcare access and resource allocation.

Purpose of the Study:

  • To update US spending estimates for mental health and SUD treatment through 2014.
  • To analyze trends in insurance financing for these conditions.
  • To examine changes in treatment utilization, particularly medication use.

Main Methods:

  • Analysis of national healthcare expenditure data up to 2014.
  • Comparison of financing shares from private insurance, Medicare, and Medicaid.
  • Examination of adult treatment utilization rates for mental health and SUDs between 2004 and 2013.

Main Results:

  • The proportion of mental health treatment expenditures financed by insurance (private, Medicare, Medicaid) rose from 44% in 1986 to 68% in 2014.
  • In contrast, the insurance share for SUD treatment financing remained largely unchanged (45% in 1986 to 46% in 2014).
  • Adult mental health treatment increased from 12.6% to 14.6% (2004-2013), driven by medication use, while SUD treatment rates remained low (1.2%-1.3%) despite increased medication use.

Conclusions:

  • A significant shift towards insurance-based financing occurred for mental health care.
  • Substance use disorder treatment financing and utilization show less progress compared to mental health care.
  • Increased reliance on medications is a key trend in both mental health and SUD treatment, but access to broader treatment settings for SUDs remains limited.