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HPD reanalysis: outpatient professional services now the largest share of commercial behavioral-health claims spending
Summary
Using OKA’s definitions, Friedman Healthcare and OKA re-ran HPD analyses and found outpatient professional non-primary-care services rose from ~33% to 44% of commercial claims-based behavioral-health spending (2018–2023); mental health comprises ~88–89% of BH spending while substance-use disorder spending (~11–12%) is more concentrated in inpatient/residential care.
Vanayak Sinha, a senior consultant with Friedman Healthcare, presented results of a Healthcare Payments Data (HPD) reanalysis using OKA’s behavioral-health definitions. Comparing the Friedman/Milbank specifications to OKA’s expanded diagnosis and NDC lists, analysts found minimal differences in the overall measurement for commercial claims-based behavioral-health spending (no more than 0.1 percentage point of total medical expense).
Key findings for commercial claims-based spending (2018–2023): outpatient professional non-primary-care services represented the largest and…
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