Medicare Mental Illness

Depression Among the Elderly & Medicare Part D

How did the enactment of Medicare Part D affect the mental health of the elderly? This is the question Ayyagari and Shane attempt to answer in their recent JHE paper.

The authors use data from the Health and Retirement Study (HRS) between 2010 and 2010 to measure changes in depressive symptoms among patients aged 60-70. The key endpoint of interest is an abridged version of the Center for Epidemiologic Studies (CESD) scale. HRS has detailed measures of mental health, demographic, and socioeconomic variables, it does not include detailed information on prescription drug use or spending. To address this shortcoming, the authors also use the Medical Expenditure Panel Survey (MEPS).

In the baseline specification, the authors use a difference-in-difference approach to measure difference CESD levels between 65-70 years olds and 60-64 year olds before and after 2006 (when Medicare Part D was implemented). The authors also use an IV approach. The measure whether or not the individual had prescription drug coverage and use whether the person was age ≥65 after 2006 as an instrument for prescription drug coverage.

The authors found the found that depressive symptoms among the elderly decreased significantly after the introduction of Medicare Part D.

Using our preferred specification, we find that Medicare Part D resulted in a 14.8% decline in depressive symptoms and a 21.2% decline in the likelihood of experiencing 3 or more depressive symptoms…our estimates are comparable to estimates from prior studies on the relationship between insurance coverage and mental health.

Increasing insurance coverage does increase premiums, but it also improves access to care and–at least in the case of mental health–dramatically improves patient outcomes.


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