Health insurance claims for behavioral health treatment increased more than 100 percent in the 10-year-period between 2007 and 2017, a new study finds, with young people bearing a large share of those diagnoses. The study said that claim lines with behavioral health diagnoses increased 108 percent as a percentage of all medical claim lines from 2007 to 2017.

The white paper from FAIR, a nonprofit that studies the health insurance industry, drew on more than 28 billion private health claim records. The 2007-to-2017 time period may reflect an increase of claims reporting as well as possible increases in incidence, since it covers the years when federal law began requiring parity in coverage for mental health coverage in the U.S.

Disproportionate numbers for younger people

The study highlighted significant increases of behavioral health diagnoses over ten years among young people, including:

The pediatric share of claim lines for major depressive disorder increased from 15 percent to 23 percent.
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 percent—more than for any other age group.

“Young Americans are bearing much of the burden of the increase in mental health disorders,” the study said. “While major depression prevalence increased overall from 2005 to 2015, the rate of increase was faster in youth. Children's hospital encounters for suicidal ideation or suicide attempts more than doubled as a percentage of all encounters at these facilities from 2008 to 2015.”

Substance abuse—opioid abuse takes center stage

Not surprisingly, opioid dependence showed growth over the ten-year period, overtaking alcohol dependence as the top claim for substance abuse. Still, although the opioid abuse claim lines increased dramatically during those years, the claims fell 50 percent from 2015 to 2017. In 2017, opioid dependency claims represented 37 percent of claims; alcohol dependence represented 28 percent of claims.

Young people—individuals 18 years of age and under—had a higher share of cannabis abuse claims, 32 percent, than any other age group in 2017.

Health reform leads to better reporting

The white paper noted that the increases in diagnoses for behavioral health issues in private health claims may be due to increased access to mental health services, following the passage of the federal Mental Health Parity Act in 2008.

“Before passage of the Mental Health Parity Act, many insurance plans covered behavioral health treatment at lower levels than non-behavioral care, for example, by requiring higher cost sharing or limiting treatment to a specific number of days or visits,” the report noted. “After passage of the Mental Health Parity Act, a plan's coverage for behavioral health treatment was required to be at parity with its coverage for medical-surgical treatment.”

In addition, the passage of the Affordable Care Act (ACA) may have something to do with the increase in behavioral health diagnoses among younger Americans, the study said. The ACA, implemented in 2010, enabled young people to remain on their parents' private insurance until age 26, increasing access to private insurance for those younger adults. FAIR's whitepaper pointed to a study that found the likelihood of having private coverage increased by 5.1 percent for 19- to 25-year-olds than for those aged 26-34.

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Behavioral health claims jump, driven by young people

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