Spillover Effects of Massachusetts Health Reform on Mental Health Use by VA and Medicare Dual Enrollees

Adm Policy Ment Health. 2019 Mar;46(2):145-153. doi: 10.1007/s10488-018-0900-z.

Abstract

Older veterans can obtain care from the Veterans Affairs Health System (VA), Medicare or both. We examined whether their use of mental health care was impacted by capacity effects stemming from younger, uninsured veterans' enrolling in VA to satisfy the individual mandate within Massachusetts Health Reform (MHR). Using administrative data, we applied a difference-in-difference approach to compare pre-post changes in mental health use following MHR implementation. Findings indicated MHR was associated with increases in use through Medicare and the probability of dual VA-Medicare use. These results provide support for the possibility that limited capacity led to care seeking outside VA.

Keywords: Access; Healthcare reform; Mental health; Utilization; Veterans affairs.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Fee-for-Service Plans
  • Female
  • Health Care Reform / legislation & jurisprudence
  • Health Care Reform / statistics & numerical data*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Male
  • Massachusetts
  • Medicare / statistics & numerical data*
  • Mental Health Services / economics
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • United States
  • United States Department of Veterans Affairs / statistics & numerical data*