Workplace Mental Health Benefits & Selective Contracting

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DESCRIPTION (provided by applicant): The need for a healthy and productive workforce in a global economy has brought renewed interest in studies of how changes in corporate benefit policies for mental health treatment affect broader healthcare utilization and the productivity of workers. The goal of our study is to examine the effects of an innovative mental health benefit design change by a large national corporation. Specifically, restrictions on mental health treatment were reduced, patient out-of-pocket costs were decreased, and a company-wide effort was made to destigmatize mental health treatment. Concurrently, a network of mental health providers was initiated, the goal of which was to offer employees treatment options from quality providers. Using claims data for medical, pharmaceutical, and mental health in conjunction with linked employee and provider records in the pre- and post-benefit change period, we propose to examine the following research questions: 1) How did the overall benefit policy change affect mental health treatment initiation, intensity, and quality? 2) How did the overall benefit policy change impact non-mental health costs? 3) How did the benefit policy change impact short-term disability. 4) To what extent are changes in treatment intensity due to selecting providers that already expouse the company's treatment philosophy (contracting effect) or changes in provider's behavior in order to join the network (adaption effect)? 5) What are the costs of selective contracting to patients and providers? 6) Were quality, efficient providers selected? Adopting a comprehensive strategy that improves access to treatment of mental illness may have important long run benefits to employers and employees. Moreover, selective contracting has the potential to reward efficient providers and may be less costly and controversial than attempting to change the way providers treat patients through utilization management. Our study will offer lessons from which other purchasers, including the federal government, may learn.