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The Fragmentation of U.S. Health CareCauses and Solutions$
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Einer Elhauge

Print publication date: 2010

Print ISBN-13: 9780195390131

Published to Oxford Scholarship Online: May 2010

DOI: 10.1093/acprof:oso/9780195390131.001.0001

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Fragmentation in Mental Health Benefits and Services

Fragmentation in Mental Health Benefits and Services

A Preliminary Examination into Consumption and Outcomes

Chapter:
(p.279) 12 Fragmentation in Mental Health Benefits and Services
Source:
The Fragmentation of U.S. Health Care
Author(s):

Barak Richman

Daniel Grossman

Frank Sloan

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780195390131.003.012

This chapter discusses consumption disparities in outpatient mental health services among a diverse insured working population. It first observes that despite paying equal insurance premiums and enjoying equal insurance coverage, lower-income and non-white workers consume fewer insurance benefits than their white and higher-income coworkers. It finds no evidence, however, that this disparity leads to adverse health outcomes. It additionally finds that non-whites and low-income individuals are more likely than their white and high-income counterparts to obtain mental health care from general practitioners rather than mental healthcare providers, and nearly twice as likely not to follow up with a mental health provider after hospitalization with a mental health diagnosis. These findings suggest that low-income and non-white individuals might be paying for health services that primarily benefit their white and more affluent coworkers. Many of these regressive consequences can be attributed to mental health insurance carve-outs, which are a product of the fragmented delivery of health care.

Keywords:   mental healthcare delivery, mental health consumption, health disparities, healthcare consumption disparities, health regressivity, mental health insurance, insurance carve-outs, fragmented health care

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