Impact of Deductibles on Initiation and Continuation of Psychotherapy for Treatment of Depression

Objective To estimate the impact of deductibles on the initiation and continuation of psychotherapy for depression. Data Sources/Study Setting Data from health care encounters and claims from Group Health Cooperative, a large integrated health care system in Washington State, was merged with information from a centralized behavioral health triage call center to conduct study analyses. Study Design A retrospective observational design using a hierarchical logistic regression model was used to estimate initiation and continuation probabilities for use of psychotherapy, adjusting for key sociodemographic/economic factors and prior use of behavioral health services relevant to individual decisions to seek mental health care. Data Collection/Extraction Methods Analyses were based on merged datasets on patient enrollment, insurance benefits, use of mental health and general medical services and information collected by a triage specialist at a centralized behavioral health call center. Principal Findings Among individuals with unmet deductibles between $100 and $500, we found a statistically significant lower likelihood of making an initial visit, but there was no statistically significant effect on making an initial or subsequent visit among individuals that had met their deductible. Conclusions Unmet deductibles appear to influence the likelihood of initiating psychotherapy for treating depression.