The Effects of Preferred Provider Options in Fee-For-Service Plans on Use of Outpatient Mental Health Services by Three Employee Groups

Descriptions of how preferred provider organizations (PPOs), offered as options to employees enrolled in fee-for-service plans, affected use of outpatient mental health services are provided. Data are from the RAND Preferred Provider Organization Study, which has a sample of employees who enrolled in fee-for-service plans 1 year before and 2 years after a PPO option was offered by three employers in two U.S. sites. To study effects of the optional PPOs on access to mental health care, usage patterns among those who initially stated that they did or did not intend to use PPO providers were examined. By the end of the second post-PPO year, employees had a similar annual probability of having an outpatient mental health visit whether or not they initially intended to use PPO providers. However, during the first post-PPO year, there was a decrease in the probability of use for those initially intending to use PPO providers, relative to those who did not intend to do so, among employees who had no regular medical provider. To study effects of the PPO option on usage levels of mental health care services, users of mental health services who primarily visited PPO were compared with those who primarily visited non-PPO providers. Users who visited PPO providers had significantly lower levels of use, controlling for other factors, than those who primarily visited non-PPO providers. Therefore, despite lower cost sharing for services received from PPO providers, the PPO option appeared to lower outpatient mental health care costs while having no more than a transient effect on access. This study did not evaluate mental health outcomes

Business · Family medicine · Health care · Health maintenance · Mental health · Preferred provider organization · Psychiatry · Service (business) · Service provider · Geriatric Care and Nursing Homes · Healthcare Policy and Management · Marketing · Medicine · Mental Health Treatment and Access

• Health care expenditures after introduction of a gatekeeper and a global budget in a Swiss health insurance plan

  Jean-François Etter, J F Etter et al.•Journal of Epidemiology and…•1998

  Add to list

• A Comparison of Alternative Models for the Demand for Medical Care

  Naihua Duan, Willard G Manning et al.•Journal of Business and Economic…•1983

  Add to list

• Sociodemographic Factors and the Use of Outpatient Mental Health Services

  Kenneth B Wells, Willard G Manning et al.•Medical Care•1986

  Add to list

• Use of a Preferred Provider Plan by Employees of the City of Seattle

  Paula Diehr, Nancy Silberg et al.•Medical Care•1990

  Add to list

• Use of Ambulatory Health Care Services in a Preferred Provider Organization

  Paula Diehr, Diane P Martins et al.•Medical Care•1987

  Add to list

• The Sensitivity of Mental Health Care Use and Cost Estimates to Methods Effects

  Kenneth B Wells, Willard G Manning et al.•Medical Care•1984

  Add to list

• The MOS Short-form General Health Survey

  Anita L Stewart, Ron D Hays et al.•Medical Care•1988

  Add to list