Health Care Utilization Patterns and Costs of Care: A Longitudinal Analysis of the Implications of the Mental Health Parity Act for Those with Comorbid Diabetes and Depression Diagnoses
*Molly Nowels, University of Colorado Denver Department of Family Medicine
Keywords: diabetes, depression, mental health, Affordable Care Act
Rates of depression in individuals with diabetes are twice that of the general population in the United States. The current study will examine health care utilization patterns and cost of care among individuals with diabetes with and without comorbid depression pre- and post-Affordable Care Act and Mental Health Parity implementation. Using claims data for individuals enrolled in employer-sponsored plans in states with over 30% coverage penetration, we will employ a longitudinal multilevel modeling analysis for individuals continuously enrolled in the Health Care Cost Institute data set (approximately 7.8 million unique patients) from 2009 to 2013. Outcome measures will include utilization measures such as ED visits, hospitalizations, primary care visits, behavioral health visits, and overall costs of care. We anticipate finding a significant difference in utilization and cost of care when comparing patients with diabetes with and without comorbid depression. Findings may provide policymakers with evidence for potential legislation around improving behavioral health and primary care.