Journal ArticleDOI
Cost sharing for substance abuse and mental health services in managed care plans.
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TLDR
Level of cost sharing for outpatient substance abuse treatment is very similar to that for mental health, with around 40 percent of products requiring copayments of $20 or more and another 15 percent requiring coinsurance of 50 percent.Abstract:
Recent initiatives to improve private insurance coverage for substance abuse and mental health in the United States have mostly focused on equalizing coverage limits to those found in general medical care. Federal law does not address cost sharing (copayments and coinsurance), which may also deter needed care or impose significant financial burdens on enrollees. This article reports on cost sharing requirements for outpatient care in a nationally representative sample of managed care plans in 1999. Levels of cost sharing are substantial, with around 40 percent of products requiring copayments of $20 or more and another 15 percent requiring coinsurance of 50 percent. Cost sharing for outpatient substance abuse treatment is very similar to that for mental health. Compared to general medical care, at least 30 percent of products impose higher cost sharing for substance abuse and mental health treatment. Future parity initiatives should be examined for how they address differences in cost sharing as well as limits.read more
Citations
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Journal ArticleDOI
Cost-sharing: a blunt instrument.
Dahlia K. Remler,Jessica Greene +1 more
TL;DR: The empirical evidence published since the mid-1980s about cost-sharing's effect on utilization, expenditures, health, and adverse consequences is reviewed, including how the effects vary by form of care, by health status, and by sociodemographic characteristics.
Cost-sharing: effects on spending and outcomes.
TL;DR: Research consistently shows demand for health care is price sensitive, but it is unlikely cost-sharing will significantly slow the growth of health care spending, and low-income populations are disproportionately affected by increased cost- sharing.
Journal ArticleDOI
The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral health utilization and expenditures among “carve-out” enrollees
Susan L. Ettner,Jessica M. Harwood,Amber Thalmayer,Michael K. Ong,Haiyong Xu,Michael J. Bresolin,Kenneth B. Wells,Chi-Hong Tseng,Francisca Azocar +8 more
TL;DR: It is found that the primary impact of MHPAEA among carve-out enrollees may have been a reduction in patient financial burden, and somewhat more robust evidence that costs shifted from patients to plans is found.
Journal ArticleDOI
A research agenda for economic evaluation of substance abuse services.
TL;DR: In this article, the authors present background information on the economics of addiction health services, reviews recent empirical and methodological contributions, and provides 15 research recommendations for the next wave of research.
Journal ArticleDOI
Insurance parity and the use of outpatient mental health care following a psychiatric hospitalization.
TL;DR: Medicare enrollees in health plans with insurance parity for mental health and primary care have markedly higher use of clinically appropriate mental health services following a psychiatric hospitalization.
References
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BookDOI
From Asylum to Community: Mental Health Policy in Modern America
TL;DR: Examining changes in mental health care between 1940 and 1970, Grob shows that community psychiatric and psychological services grew rapidly, while new treatments enabled many patients to lead normal lives.
Journal ArticleDOI
Management of mental health and substance abuse services: state of the art and early results.
TL;DR: Managed care refers to capitated practice, utilization management, and programs of case management for persons with mental illness and problems of substance abuse, which differ substantially, and within each type are variations.
Journal Article
The design of the community tracking study: a longitudinal study of health system change and its effects on people.
Peter Kemper,David Blumenthal,Janet M. Corrigan,Peter J. Cunningham,S M Felt,Joy M. Grossman,L T Kohn,C E Metcalf,R F St Peter,R C Strouse,Paul B. Ginsburg +10 more
TL;DR: The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effects on People is the first in what I hope will be a series of occasional articles describing large-scale data collection efforts and plans for analyzing such data.
Journal ArticleDOI
The Demand for Episodes of Mental Health Services
TL;DR: It is found that outpatient mental health use is more responsive to price than is outpatient medical use, but not as responsive as most observational studies have indicated.
Book
Mental Health and Social Policy: The Emergence of Managed Care
TL;DR: This chapter discusses the development of Mental Health Policy in the United States, the role of insurance, and future trends in Innovative Mental Health Services.