Panel: The Effects of Mental Health Care Access: Evidence from the United States
(Health Policy)

Thursday, November 8, 2018: 1:45 PM-3:15 PM
Wilson C - Mezz Level (Marriott Wardman Park)

*Names in bold indicate Presenter

Panel Chairs:  Sandra Decker, Agency for Healthcare Research and Quality
Discussants:  Rebecca Myerson, University of Southern California and Scott P Laughery, Congressional Budget Office

The Impact of the Maryland Medicaid Health Home Waiver on Emergency Department and Inpatient Utilization Among Individuals with Serious Mental Illness
Sachini Bandara, Gail L. Daumit, Alene Kennedy-Hendricks and Beth McGinty, Johns Hopkins University

Implementing Parity for Mental Health and Substance Use Treatment in Medicaid
Marguerite Burns, University of Wisconsin, Madison, Laura Dague, Texas A&M University and Brendan Saloner, Johns Hopkins University

Policymakers and mental health advocates contend that inaccessible psychiatric care is associated with a number of externalities, such as increased emergency department utilization, and incarceration. This interdisciplinary panel brings together several papers that leverage quasi-experimental empirical frameworks to evaluate this relationship. In the first paper, Y. Nina Gao uses a feature of hospital cost structures to examine the effect of inpatient psychiatric bed reductions and additions on emergency department utilization and incarceration. Similarly, in the second paper, Jessica Monnet exploits Medicaid's Institutions for Mental Disease exclusion to study the effect of reduced insurance coverage for inpatient psychiatric care on emergency department utilization. While the first two papers tend to focus on the effect of reduced access to psychiatric care, the next two papers focus on the effect of improved access to care. That is, in the third paper, Beth McGinty and coauthors examine the effect of Maryland's Medicaid Health Home services waiver on emergency department and inpatient utilization. And in the final paper, Marguerite Burns and coauthors exploit a natural experiment in Wisconsin to evaluate the effect of parity laws for mental health and substance use disorder (MHSUD) services for childless adult Medicaid beneficiaries on MHSUD outpatient and emergency department utilization.

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