The aims of this study are to characterize a large sample of employment based health care contracts and to determine how insurance design and vendor risk-sharing arrangements affect the use and expenditures of behavioral health care services. We will identify those individuals who are users of intensive services (hospitalizations, intensive outpatient services or partial hospital services) for special study. Finally, we will develop measures to examine the quality of health care across contracts. To accomplish these aims we will review approximately 1,000 contracts held by between a specific managed behavioral health care vendor as of January 1, 1997. We will gather all behavioral mental health claims filed under these contracts for the relevant contract year, and for the intensive users we will (where possible) obtain their medical, surgical and pharmaceutical claims. We will use the Standard Industry Code (SIC) and other data to characterize the firms who purchase these contracts. We will use data from the Area Resource File, the U.S. census and other sources to characterize the market areas where contracts are in effect. We will develop statistical models to examine the relationship between utilization and expenditures under a contract with respect to contract characteristics, firm characteristics and market characteristics.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH056925-03
Application #
2890917
Study Section
Services Research Review Committee (SER)
Program Officer
Rupp, Agnes
Project Start
1997-04-01
Project End
2001-03-31
Budget Start
1999-04-01
Budget End
2001-03-31
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Peele, Pamela B; Xu, Ying; Kupfer, David J (2003) Insurance expenditures on bipolar disorder: clinical and parity implications. Am J Psychiatry 160:1286-90
Peele, Pamela B; Lave, Judith R; Kelleher, Kelly J (2002) Exclusions and limitations in children's behavioral health care coverage. Psychiatr Serv 53:591-4
Peele, Pamela B; Lave, Judith R; Songer, Thomas J (2002) Diabetes in employer-sponsored health insurance. Diabetes Care 25:1964-8
Lave, Judith R; Peele, Pamela B; Xu, Ying et al. (2002) An exploratory analysis of behavioral health care use within families. Psychiatr Serv 53:743-8
Lave, J R; Peele, P B (2000) Datapoints: the distribution of payments for behavioral health care. Psychiatr Serv 51:723
Peele, P B; Lave, J R; Xu, Y (1999) Benefit limits in managed behavioral health care: do they matter? J Behav Health Serv Res 26:430-41