Judith Liu, Melbourne Institute - How do patients with mental disorders respond to complex health insurance cost-sharing design?

Title: How do patients with mental disorders respond to complex health insurance cost-sharing design?

Abstract: Over the past decade, public and private health insurance providers have implemented benefit designs that shift more of the financial burden to patients using mechanisms such as deductibles and coverage gaps. From the patient’s perspective, this creates complex price structures where prices change throughout the year depending on utilization. There is still limited evidence on how patients respond to these complex designs, especially among patients with mental disorders. US Medicare recently eliminated a complex coverage structure, providing an excellent opportunity to conduct an in-depth study of how individuals react to these types of benefit designs. The Medicare prescription drug benefit (Part D) was initially designed with a large coverage gap where beneficiaries were responsible for 100% of drug costs. Beginning in 2011, the coverage gap began to close as a result of the Affordable Care Act. In this paper, we take advantage of the fact that a subset of Medicare beneficiaries, those who qualify for the low-income subsidy, have remained exempt from the coverage gap and therefore have not been affected by gap closure policies. We employ methods for causal inference in observation data using a difference-in-differences approach to how Medicare beneficiaries respond to complex cost-sharing insurance design and how this policy affects patient healthcare use and outcomes. We compare how general Medicare population and patients with mental disorders respond to the policy change differently.

Presenter: Judith Liu, Melbourne Institute

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