Assessing the Effect of Behavioral Health Conditions on Out-of-Pocket Expenses: A Comparison of Two National Surveys

Healthcare is one of the largest sectors in the US economy and medical spending has drastically increased over the last few years. Also rising is the number of behavioral health cases. It is estimated a quarter of the US adult population has a behavioral health or substance abuse issue. Consequently, behavioral health expenditures accounts for 7.5%, or $220 billion, of medical related spending. The U.S. Congress passed the Affordable Care Act (ACA) in 2013 with the intention of expanding insurance coverage and decreasing medical expenses. Researchers continue to debate whether the ACA is achieving its intended goals. In order to track medical expenses over time, government and private organizations conduct verified surveys to capture healthcare costs. While valuable, some surveys take years to compile, validate, and release data for detailed analysis. Demands for faster data availability have led to the rise of self-reported, internet-based surveys. However, there is concern regarding the validity of this self-reported data, especially related to the implementation of the ACA and out-of-pocket spending. This research studies the effect of the ACA for behavioral health patients and the objectives are two-fold. First, it will explore if the self-reported, internet-based Health Reform Monitoring Survey (HRMS) predicts out-of-pocket medical spending of the more comprehensive and validated Medical Expenditure Panel Survey (MEPS) for behavioral health conditions. Secondly, the study will explore the impact of ACA implementation on overall costs of the those who report a behavioral health condition. The results show that HRMS does corroborate the results of MEPS. Behavioral health patients have increased costs, especially if they another medical condition. With the substantiation of information in the HRMS, the paper further explores questions regarding the ACA. The results showed several significant results for behavioral health patients: the ACA has not reduced out-of-pocket spending between 2013-2017; purchasing insurance through the ACA marketplace did not have a significant impact on out-of-pocket spending; behavioral health patients in the ACA intended lower poverty levels showed decreased out-of-pocket spending; and patients covered with public insurance had a decrease in out-of-pocket spending while those who held private insurance or were uninsured had increased out-of-pocket expenses. This research provides support for the use of faster, self-reported, internet-based surveys as a basis for decision-making regarding future health policy issues. Advisor: Dr. Qiushi Chen, Assistant Professor of Industrial and Manufacturing Engineering



Work Title Assessing the Effect of Behavioral Health Conditions on Out-of-Pocket Expenses: A Comparison of Two National Surveys
Penn State
  1. Lauren Marie Bullis
  1. Health Analysis; Healthcare Spending
License All rights reserved
Work Type Research Paper
Publication Date 2020
Deposited April 07, 2020




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