TY - JOUR AU - Berndt,Ernst R. AU - Frank,Richard G. AU - McGuire,Thomas G. TI - Alternate Insurance Arrangements and the Treatment of Depression: What Are the Facts? JF - National Bureau of Economic Research Working Paper Series VL - No. 5813 PY - 1996 Y2 - November 1996 UR - http://www.nber.org/papers/w5813 L1 - http://www.nber.org/papers/w5813.pdf N1 - Author contact info: Ernst R. Berndt MIT Sloan School of Management 100 Main Street, E62-518 Cambridge, MA 02142 Tel: 617/253-2665 Fax: 617-227-0880 E-Mail: eberndt@mit.edu Richard Frank Department of Health Care Policy Harvard Medical School 180 Longwood Avenue Boston, MA 02115 Tel: 617/432-0178 Fax: 617/432-1219 E-Mail: frank@hcp.med.harvard.edu Thomas McGuire Department of Health Care Policy Harvard Medical School 180 Longwood Avenue Boston, MA 02115 Tel: 617/432-3536 E-Mail: mcguire@hcp.med.harvard.edu AB - Using insurance claims data from nine large self-insured employers offering 26 alternative health benefit plans, we examine empirically how the composition and utilization for the treatment of depression vary under alternative organizational forms of insurance (indemnity, preferred provider organization networks or PPOs, and mental health carve-outs), and variations in patient cost-sharing (copayments for psychotherapy and for prescription drugs). Although total outpatient mental health/substance abuse (MHSA) expenditures per treated individual do not vary significantly across insurance forms, the depressed outpatient is more likely to receive anti-depressant drug (ADD) medications in PPOs and carve-outs than under indemnity insurance. Those individuals facing higher copayments for psychotherapy are more likely to receive ADD medications. For those receiving ADD treatment, increases in prescription drug copay tend to increase the share of ADD medication costs accounted for by the newest (and more costly) generation of drugs, the selective serotonin reuptake inhibitors. ER -