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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

(p.279) 12 Fragmentation in Mental Health Benefits and Services
The Fragmentation of U.S. Health Care

Barak Richman

Daniel Grossman

Frank Sloan

Oxford University Press

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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