ALTERNATIVE INSURANCE ARRANGEMENTS AND THE TREATMENT OF DEPRESSION - WHAT ARE THE FACTS

Using insurance claims data from nine large self-insured employers off ering 26 alternative hearth benefit plans, we examine empirically how the composition and utilization for the treatment of depression vary u nder alternative organizational forms of insurance (indemnity, preferr ed provider organization networks, and mental health carve-outs), and variations in patient cost-sharing (copayments for psychotherapy and f or prescription drugs). Although total outpatient mental health and su bstance abuse expenditures per treated individual do not vary signific antly across insurance forms, the depressed outpatient is more likely to receive anti-depressant drug medications in preferred provider orga nizations and carve-outs than when covered by indemnity insurance. Tho se individuals facing higher copayments for psychotherapy are more lik ely to receive anti-depressant drug medications. For those receiving t reatment, increases in prescription drug copayments tend to increase t he share of anti-depressant drug medication costs accounted for by the newest (and more costly) generation of drugs, the selective serotonin reuptake inhibitors.