The relationship between health insurance characteristics and the use of behavioral health treatment services

Rationale: Many people delay health care treatment and some never seek care from the formal health care system. It is estimated that 28 percent of the U.S. adult population in any year has a diagnosable mental or addictive disorder, and yet less than one-third of these individuals seek treatment. Objective: The objective of this study is to estimate the effect of health insurance characteristics on mental health and substance use (MH/SA) treatment utilization for privately-insured employees and their dependents. Methodology: Using a two-part model, I estimate the effect of MH/SA health insurance characteristics on the decision to use MH/SA services and, conditional on use, the number of treatment days. Probability of use is modeled using a random-effects logit model and the number of treatment days is modeled using a random-effects negative binomial model. Data used are private insurance enrollment and claims data for 1997-1998 from MEDSTAT's Marketscan® database. Results: Individuals are found to respond to expected out-of-pocket expenses for outpatient MH care, but this response is very small. Furthermore, MH/SA health characteristics appear to have little or no effect on SA treatment utilization for spouses and other dependents. My models show that the effect of MH/SA health insurance varies for individuals by their relationship to the policy (i.e., primary beneficiary versus spouse or other dependent). Primary beneficiaries are found to be more responsive to these characteristics iv than spouses and other dependents. When significant, the requirement of precertification by an employee assistance program (EAP) has a negative effect on MH/SA utilization. Conclusions: My findings suggest that the response to cost-sharing for MH care demand is similar to general medical care and brings into question previous arguments against parity for MH/SA treatment. Finally, the role of an EAP is not straightforward. Rather than facilitating treatment access, EAP precertification may create an obstacle to treatment and discourage utilization. However, it is also possible that EAP precertification may decrease formal utilization by providing some brief MH/SA services to individuals with milder conditions

Healthcare Utilization of Individuals with Opiate Use Disorders: An Analysis of Integrated Medicaid and State Mental Health/Substance Abuse Agency Data

Data from the Substance Abuse and Mental Health Services Administration’s Integrated Database (IDB) were used to examine the service use patterns of individuals with possible opiate use disorders in Washington State. Results indicate that regardless of Medicaid enrollment status, individuals who received mental health (MH) or substance abuse (SA) services only through state agencies received no inpatient substance abuse service. Furthermore, when compared with individuals who received at least one MH/SA service through Medicaid, those who received services only through the state agencies were less likely to have received any MH services and were more likely to have received residential SA services. This analysis highlights the importance of using integrated client data in providing a more comprehensive understanding of services to inform policy and raises significant questions about how regulatory requirements affecting different funding mechanisms might drive settings of care in ways not related to the care needed

Tethered Particle Motion as a Diagnostic of DNA Tether Length

The tethered particle motion (TPM) technique involves an analysis of the Brownian motion of a bead tethered to a slide by a single DNA molecule. We describe an improved experimental protocol with which to form the tethers, an algorithm for analyzing bead motion visualized using differential interference contrast microscopy, and a physical model with which we have successfully simulated such DNA tethers. Both experiment and theory show that the statistics of the bead motion are quite different from those of a free semiflexible polymer. Our experimental data for chain extension versus tether length fit our model over a range of tether lengths from 109 to 3477 base pairs, using a value for the DNA persistence length that is consistent with those obtained under similar solution conditions by other methods. Moreover, we present the first experimental determination of the full probability distribution function of bead displacements and find excellent agreement with our theoretical prediction. Our results show that TPM is a useful tool for monitoring large conformational changes such as DNA looping

Very bright orange fluorescent plants: endoplasmic reticulum targeting of orange fluorescent proteins as visual reporters in transgenic plants

Background The expression of fluorescent protein (FP) genes as real-time visual markers, both transiently and stably, has revolutionized plant biotechnology. A palette of colors of FPs is now available for use, but the diversity has generally been underutilized in plant biotechnology. Because of the green and far-red autofluorescent properties of many plant tissues and the FPs themselves, red and orange FPs (RFPs, and OFPs, respectfully) appear to be the colors with maximum utility in plant biotechnology. Within the color palette OFPs have emerged as the brightest FP markers in the visible spectra. This study compares several native, near-native and modified OFPs for their “brightness” and fluorescence, therefore, their usability as marker genes in transgenic plant tissues. Results The OFPs DsRed2, tdTomato, mOrange and pporRFP were all expressed under the control of the CaMV 35S promoter in agroinfiltration-mediated transient assays in Nicotiana benthamiana. Each of these, as well as endoplasmic reticulum (ER)-targeted versions, were stably expressed in transgenic Nicotiana tabacum and Arabidopsis thaliana. Congruent results were observed between transient and stable assays. Our results demonstrated that there are several adequate OFP genes available for plant transformation, including the new pporRFP, an unaltered tetramer from the hard coral Porites porites. When the tandem dimer tdTomato and the monomeric mOrange were targeted to the ER, dramatic, ca. 3-fold, increase in plant fluorescence was observed. Conclusions From our empirical data, and a search of the literature, it appears that tdTomato-ER and mOrange-ER are the two highest fluorescing FPs available as reporters for transgenic plants. The pporRFP is a brightly fluorescing tetramer, but all tetramer FPs are far less bright than the ER-targeted monomers we report here

A Multi-Institutional Partnership Catalyzing the Commercialization of Medical Devices and Biotechnology Products.

The commercialization of medical devices and biotechnology products is characterized by high failure rates and long development lead times particularly among start-up enterprises. To increase the success rate of these high-risk ventures, the University of Massachusetts Lowell (UML) and University of Massachusetts Medical School (UMMS) partnered to create key academic support centers with programs to accelerate entrepreneurship and innovation in this industry. In 2008, UML and UMMS founded the Massachusetts Medical Device Development Center (M2D2), which is a business and technology incubator that provides business planning, product prototyping, laboratory services, access to clinical testing, and ecosystem networking to medical device and biotech startup firms. M2D2 has three physical locations that encompass approximately 40,000 square feet. Recently, M2D2 leveraged these resources to expand into new areas such as health security, point of care technologies for heart, lung, blood, and sleep disorders, and rapid diagnostics to detect SARS-CoV-2. Since its inception, M2D2 has vetted approximately 260 medical device and biotech start-up companies for inclusion in its programs and provided active support to more than 80 firms. This manuscript describes how two UMass campuses leveraged institutional, state, and Federal resources to create a thriving entrepreneurial environment for medical device and biotech companies