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

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.