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Young People Disproportionately Represented in Increased Private Insurance Claims for Mental Health Diagnoses, 10-Year Study Finds

FAIR Health Study Reveals Pediatric Share of Major Depressive Disorder Claim Lines Grew From 15% in 2007 to 23% in 2017

Overall, Opioid Dependence Claim Lines Across All Age Groups Collectively Fell 50% From 2015 to 2017

Children and young adults under the age of 23 were disproportionately represented in the increase in private insurance claim lines (a claim line is an individual procedure or service listed on an insurance claim) with mental health diagnoses from 2007 to 2017, according to a new white paper from FAIR Health, a national, independent, nonprofit organization dedicated to bringing transparency to health care costs and health insurance information.

At a time of widespread concern about evidence of a nationwide increase in behavioral health disorders, including both mental health and substance use disorders, FAIR Health drew on data from its database of over 28 billion private healthcare claim records—the largest in the country—to analyze behavioral health trends and patterns in the decade from 2007 to 2017. That period spans the time prior to and after the passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which required a plan's coverage for behavioral health treatment to be at parity with its coverage for medical-surgical treatment.

Among the findings are the following:

• Claim lines with behavioral health diagnoses increased 108% as a percentage of all medical claim lines from 2007 to 2017.

• In keeping with other researchers' findings that young people are bearing much of the burden of the increase in mental health disorders, FAIR Health found that the pediatric population (defined as ages 0–22, to include people of college age) was disproportionately represented in the increase in claim lines with mental health diagnoses in the period 2007–2017. For example:

• The pediatric share of claim lines for major depressive disorder increased from 15% to 23%.

• Claim lines for generalized anxiety disorder rose by greater percentages for individuals of college age (19–22) and high school age (14–18) than any adult group.

• For adjustment disorders, claim lines for young adults (ages 19–30, including college-age individuals) increased 78%—more than for any other age group.

• Opioid dependence claim lines increased overall 1,180% from 2007 to 2017—but fell 50% from 2015 to 2017.

• "Other stimulant dependence" (dependence on stimulants other than cocaine) was the substance use disorder with the greatest increase in claim lines from 2007 to 2017 (3,490%), despite constituting a relatively small percentage of all medical claim lines.

• From 2007 to 2017, claim lines associated with major depressive disorder and generalized anxiety disorder became more common by comparison to claim lines for all medical diagnoses in most parts of the country—except the South.

FAIR Health President Robin Gelburd comments: "At a time of change in the nation's behavioral health, we are pleased to use our unparalleled data repository to shed light on many aspects of both mental health and substance use disorders. Our study provides a strong foundation of key indicators of behavioral health services among the privately insured. We look forward to further studies that focus on the specific services rendered, the types of venues where patients seek care and the specialties of the health care professionals providing the services."

Source: FAIR Health