Summary
Broadly, I study access to healthcare and behavioral health services among commercially-insured populations, as well as access to VA health care for women Veterans. My research applies quantitative, econometric methods to large administrative databases. Most recently I linked plan benefit design data with patient claims to examine the direct effects of financial requirements (e.g. copayments, coinsurance and deductibles), quantitative treatment limits (e.g. annual visit limits), and non-quantitative treatment limits (e.g. utilization management) on outpatient mental health utilization and expenditures. I have also studied how a national behavioral health parity law affected plan benefit generosity and use of behavioral health services among enrollees in a large, national, managed behavioral health organization, both overall, and among a sub-set with substance use disorder diagnoses.
Publications
Peer-Reviewed Journal Articles
Park SY, Yun GW, Friedman SA, Hill K, Ryu SY, Schwenk T, Coppes MJ. Analysis of Direct-to-Consumer Healthcare Service Advertisements on Television: An application of the patient expectation framework. Health Communication. (In press) Accepted January 2022.
Friedman SA, Azocar F, Xu H, Ettner SL. Evidence of Balance Billing in Out-of-Network Behavioral Health Claims. In Press. Psychiatric Services. Accepted December 2021.
Friedman SA, Xu H, Azocar F, Ettner SL. Comparing Copayment and Coinsurance Created From Claims Data with Gold-Standard Values. In Press. Medical Care. Accepted December 2021.
Friedman SA, Shaw J, Hamilton AB, Vinekar K, Washington DL, Mattocks K, Yano EM, Phibbs CS, Johnson AM, Saechao F, Berg E, Frayne SM. Gynecologist Supply Deserts Across the VA and in the Community. In Press. Journal of General Internal Medicine. Accepted October 2021.
Park SY, Yun GW, Friedman SA, Hill K, Ryu SY, Schwenk T, Coppes MJ. . BMJ: Journal of Medical Ethics Sept 2020. doi:10.1136/medethics-2020-106458. PubMed PMID: 33106383.
Schwartz R, Frayne SM, Friedman SA, Romodan Y, Berg E, Haskell SG, Hayes P, Shaw JG. . Journal of General Internal Medicine. 2021;36(3):614-621. doi:10.1007/s11606-020-06285-0. PubMed PMID: 33063204; PubMed Central PMCID: PMC7947068.
Friedman SA, Patel K, Yan Liu, Hartzell S, Michelle K. Urine Drug Testing Among Opioid-Naïve and Long-Term Opioid Βι¶ΉΣ³» Medicaid Beneficiaries. Substance Use and Misuse. August 2020; 55(14): 2314-2320. PubMed PMID: 32835582.
Friedman SA, Xu H, Azocar F, Ettner SL. Carve-Out Plan Financial Requirements Associated with National Behavioral Health Parity.Health Services Research. 2020;55(6):924-931. doi: 10.1080/10826084.2020.1805467. PubMed PMID: 32880927; PubMed Central PMCID: PMC7704471.
Friedman SA, Ettner SL, Chuang E, Azocar F, Harwood JM, Ong M. The Effects of Three Kinds of Insurance Benefit Design Features on Specialty Mental Health Use in Managed Care. Journal of Mental Health Policy and Economics. Jun 2019;22(2):43-59. PubMed PMID: 31319375.
Thalmayer AG, Harwood JM, Friedman SA, Azocar F, Watson LA, Xu H, Ettner SL. The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Impact on Non-Quantitative Treatment Limits for Specialty Behavioral Health Care. Health Services Research. Dec 2018;53(6):4584-4608. doi: 10.1111/1475-6773.12871. PubMed PMID: 29740807; PubMed Central PMCID: PMC6232447.
Friedman SA, Azocar Francisca, Xu H, Ettner SL. The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Did Parity Differentially Affect SUD and Mental Health Benefits Offered by Behavioral Healthcare "Carve-Out" and "Carve-In" Plans? Drug and Alcohol Dependence. 2018 Sep;190:151-158. doi: 10.1016/j.drugalcdep.2018.06.008. PubMed PMID: 30032052; PubMed Central PMCID: PMC6197987.
Friedman SA, Thalmayer AG, Azocar F, Xu H, Harwood JM, Ong M, Ettner SL. The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Impact on Mental Health Financial Requirements, Among Commercial “Carve-In” Plans. Health Services Research. Feb 2018;53(1):366-388. doi: 10.1111/1475-6773.12614. PubMed PMID: 27943277; PubMed Central PMCID: PMC5785319.
Friedman SA, Xu H, Azocar F, Harwood JM, Ettner SL. The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Healthcare Utilization and Spending Among Enrollees with Substance Use Disorders. Journal of Substance Abuse Treatment. 2017 Sept. Volume 80:67-78. doi: 10.1016/j.jsat.2017.06.006. PubMed PMID: 28755776; PubMed Central PMCID: PMC6224161.
Thalmayer AG, Friedman SA, Azocar F, Harwood JM, Ettner SL. The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Impact on Quantitative Treatment Limits (QTLs). Psychiatric Services. 2017 May 1;68(5):435-442. doi: 10.1176/appi.ps.201600110. PubMed Central PMCID: 27974003.
Harwood JM, Azocar J, Thalmayer AG, Xu H, Ong M, Tseng CH, Wells KB, Friedman SA, Ettner SL. The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Healthcare Utilization and Spending Among Carve-In Enrollees. Medical Care. 2016 Feb;55(2):164-172. doi: 10.1097/MLR.0000000000000635. PubMed Central PMCID: 27632769.
Schmitt SK, Turakhia MP, Phibbs CS, Moos RH, Berlowitz D, Heidenreich P, Chiu VY, Go AS, Friedman SA, Than CT, Frayne SM. American Journal of Managed Care. 2015 Nov 1;21(11):e609-e617. PubMed PMID: 26735294.
Friedman SA, Frayne SM, Berg E, Hamilton AB, Washington DL, Saechao F, Maisel NC, Lin JY, Hoggatt KJ, Phibbs CS. Travel Time and Attrition from VHA Care Among Women Veterans: How Far is Too Far? Medical Care. 2015 Apr;53(4 Suppl 1):S15-22. doi: 10.1097/MLR.0000000000000296. PubMed Central PMCID: PMC4386926.
Holmes GM, Pink GH, Friedman SA. The Financial Performance of Rural Hospitals and Implications for Elimination of the Critical Access Hospital Program. Journal of Rural Health. 2013 Spring;29(2):140-9. doi: 10.1111/j.1748-0361.2012.00425.x. PubMed PMID: 23551644.
Friedman SA, Phibbs CS, Schmitt SK, Hayes PM, Herrera L, Frayne SM. New Women Veterans in the VHA: A Longitudinal Profile. Womens Health Issues. 2011 Jul-Aug;21(4 Suppl):S103-11. doi: 10.1016/j.whi.2011.04.025. PubMed PMID: 21724129.
Education
- Ph.D., Health Policy and Management - University of California, Los Angeles 2017
- MSPH, Health Policy and Management - University of North Carolina, Chapel Hill 2009
- BA, Economics and Mathematics - Bryn Mawr College 2005