Cost Sharing and Patterns of Mental Health Care Utilization

Deductibles and coverage ceilings are common features of health insurance. This paper proposes and tests a new method for estimating the impact of these health coverage features on demand when total demand during a particular period is not known with certainty at the beginning of the period. We use expected end-of-year price as a proxy for the notion of "effective price" first suggested by Keeler et al. (1982) in a two-stage estimation procedure. Applying the method to the demand for ambulatory mental health care in the presence of a $500 coverage ceiling yields estimated demand responses similar to those obtained by other researchers.