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OCA: MEPS estimates unreliable for tracking California behavioral-health out-of-plan spending; HPD administrative data conflicts
Summary
OCA said MEPS-based estimates of behavioral health out-of-plan spending are unreliable at the state level because of small samples and wide confidence intervals; HPD (administrative claims) data show in‑plan behavioral spending rose 2019–2022, prompting OCA to seek alternate data sources and partnerships to refine out-of-plan estimates.
OCA staff and their contractor Mathematica presented analysis intended to estimate Californians' behavioral-health spending that occurs outside health plans (out-of-plan or fully out-of-pocket). Mathematica used four years of the Medical Expenditure Panel Survey (MEPS-HC) but staff told the advisory committee that state-level sample sizes are small and the number of respondents reporting out-of-plan behavioral health spending ranged only from about 41 to 45 over the four-year window, producing wide…
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