Factors that Affect Choice of Mental Health Provider and Receipt of Outpatient Mental Health Treatment
- 277 Downloads
According to the US Department of Health and Human Services, 91 million adults live in mental health professional shortage areas and 10 million individuals have serious mental illness (SMI). This study examines how the supply of psychiatrists, severity of mental illness, out-of-pocket costs, and health insurance type influence patients’ decisions to receive treatment and the type of provider chosen. Analyses using 2012–2013 MarketScan Commercial Claims data showed that patients residing in an area with few psychiatrists per capita had a higher predicted probability of not receiving follow-up care (46.4%) compared with patients residing in an area with more psychiatrists per capita (42.5%), and those in low-psychiatrist-supply areas had a higher predicted probability of receiving prescription medication only (10.2 vs 7.6%). Patients with SMI were more likely than those without SMI to obtain treatment. A $25 increase in out-of-pocket costs had marginal impact on patients’ treatment choices.
KeywordsMental health Health insurance plan Healthcare provider Psychiatrist supply Healthcare cost
The views expressed in this article are those of the authors and do not necessarily represent those of the Substance Abuse and Mental Health Services Administration (SAMHSA) or the US Department of Health and Human Services (DHHS). Truven Health Analytics would like to acknowledge the methodological expertise given by Daniel S. Levy, PhD and Joffre Swait, PhD. We also thank Linda Lee, PhD for editorial review.
Discloser of Funding
This work was funded by the Substance Abuse and Mental Health Services Administration.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings. NSDUH Series H-49, HHS Publication No. SMA 14–4887, Rockville, MD: Center for Behavioral Health Statistics and Quality, 2014.Google Scholar
- 2.Substance Abuse and Mental Health Services Administration. Report to Congress on the Nation’s Substance Abuse and Mental Health Workforce Issues. Rockville, MD: Substance Abuse and Mental Health Services Adminsitration, 2013.Google Scholar
- 15.Heisler E, Bagalman E. The Mental Health Workforce: A Primer. Congressional Research Service, 2015.Google Scholar
- 16.Area Health Resources Files. Bethesda, MD: Health Resources and Services Administration, 2014–2015. Available online at http://ahrf.hrsa.gov/. Accessed February 20, 2017.
- 17.RTI International. Defining Mental Health and/or Substance Abuse (MH/SA) Claimants: The Medicare, Medicaid and Managed Care Analysis Project. Research Triangle Park, NC: RIT International, 2003.Google Scholar
- 19.Heiss F. Specification(s) of Nested Logit Models. Mannheim, Germany: University of Mannheim, 2002.Google Scholar
- 20.McFadden D. Conditional logit analysis of qualitative choice behaviour. In: P Zarembka (Ed). Frontiers in Econometrics. New York: Academic Press, 1974, pp. 104–142.Google Scholar
- 21.Cameron A, Trivedi P. Microeconomics Using Stata. College Station, TX: Stata Press, 2010, p. 515.Google Scholar
- 37.T. Mark, W. Olesiuk, Ali, MM, et al. Differential Reimbursement of Psychiatric Services by Psychiatrists and Other Medical Providers. Psychiatric Services. 2017; forthcoming.Google Scholar