Translating behavioral health services research into benefits policy

This article uses a 4-pronged statistical approach to examine the impact of a mental health came-out at a major employer. To examine net financial imp act of the came-out, the authors perform a pre-post, multivariate regressio n analysis of changes in costs. Using a random-effects model, the authors e xplore the ultimate financial impact of the came-out for patients and for t he firm. Using a multinomial logistic regression, they examine differing pr ogram effects by intensity of use. A fixed-effects negative binomial regres sion models the episodic nature of outpatient care, controlling for patient -specific unobserved characteristics that influence health care utilization . The came-out slightly reduced overall mental health costs and utilization while expanding entry-level access to routine services. At the same time, the specific carve-out shifted financial burdens from the firm onto high-ut ilization patients. Therefore, this came-out appears poorly suited to the c are of individuals experiencing severe and debilitating psychiatric disorde rs.