Economics and Services Research
We conduct health services and economics research to evaluate how health and social policies affect populations with mental illness and substance use disorder. We examine trends in health care use and how federal, state and local policies influence health care utilization, health outcomes and other important social indicators.
Featured Recent Research
Effects of State Policy Responses to the U.S. Overdose Crisis
Center faculty have conducted several studies focused on evaluating state responses to the worsening overdose crisis. Faculty have used econometrics and health services research methods to examine the effects of a wide variety of policies, including efforts to expand insurance coverage for substance use disorder treatment, policies to change child welfare reporting practices, and opioid prescribing policies.
- State Policy and the Breadth of Buprenorphine-Prescriber Networks in Medicaid Managed Care
- Medicaid Expansion and Racial-Ethnic Health Care Coverage Disparities Among Low-Income Adults With Substance Use Disorders
- State prescribing cap laws’ association with opioid analgesic prescribing and opioid overdose
- Changes in Buprenorphine-Naloxone and Opioid Pain Reliever Prescriptions After the Affordable Care Act Medicaid Expansion
- Association between U.S. state prenatal drug use laws and child welfare reporting in Alabama, Maryland and Utah
Effects of High Deductible Insurance Plans
High deductible health plans, which expose consumers to high out-of-pocket costs, have been identified as a method to get consumers more involved in health care decision making. Many worry that deductibles are too high and that consumers will make short-term decisions in the face of increased costs. Center faculty working in this area have advanced knowledge by estimating the effect of firms offering a HDHPS on substance use disorder and mental health services. These studies find that offering an HDHP was associated with reductions in the use of ambulatory services and medication treatment as well as large reductions in family spending. While our work shows decreases in medication use, we add nuance by showing that, conditional on starting buprenorphine treatment, HDHPs do not decrease the length of treatment episodes. We show that when mental health and substance use disorder co-occur, spending reductions are completely driven by decreases in psychotropics and SUD medication.
Measuring Mental Health and Substance Use Disorder Treatment Patterns
Center faculty are conducting multiple studies seeking to measure mental health and substance use treatment services use as well as overall health care use among key populations, including individuals with carceral involvement, individuals engaged in medication for opioid use disorder treatment, individuals with chronic pain and individuals with psychological distress.
- Estimated Use of Prescription Medications Among Individuals Incarcerated in Jails and State Prisons in the US
- A Widening Divide: Cigarette Smoking Trends Among People With Substance Use Disorder And Criminal Legal Involvement
- Trends In The Use Of Treatment For Substance Use Disorders, 2010–19
- Co-Occurring Opioid Use and Depressive Disorders: Patient Characteristics and Co-Occurring Health Conditions
- U.S. Health Care Reform and Enduring Barriers to Mental Health Care Among Low-Income Adults With Psychological Distress
- Trends in opioid and non-opioid treatment for chronic non-cancer pain and cancer pain among privately insured adults in the United States, 2012–2019
Effect of Medicaid Health Homes for Persons with Serious Mental Illness
As part of the Affordable Care Act, states had the opportunity to create Medicaid health home programs to improve mental health and somatic health care coordination for populations with serious mental illness. State Medicaid health homes varied widely in scope, administration and structure. Center faculty have examined the effects of Maryland’s health home program and find that enrollment in the program is associated with reductions in emergency department visits, increases in outpatient mental health visits, improved follow up after hospitalization but minimal effects of quality of cardiovascular care and inpatient services use.