Design of mental health benefits: Still unequal after all these years
Abstract
This paper examines recent trends in the design and organization of coverage for mental health care using data from a Henry J. Kaiser Family Foundation and Health Research and Educational Trust (KFF/HRET) national employer survey. Legislation and changes in the delivery of mental health services have altered how mental health insurance is bought and sold. However, our findings reveal that mental health coverage is still typically not offered at a level equivalent to coverage for other medical conditions. We attempt to synthesize these data with prior research as a foundation for informed debates.
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Behavioral health insurance benefits have historically been less generous than insurance benefits for medical and surgical care in the employer-sponsored insurance market.
“Despite the fact that health insurance is supposed to protect individuals from financial shocks associated with healthcare expenses, behavioral health (BH) insurance benefits, which cover MH and SUD services, have historically been less generous than insurance benefits for medical and surgical care in the employer-sponsored insurance market (Barry et al., 2003; Hodgkin, Horgan, Garnick, & Merrick,”
From The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders (2017) · cites this paper as Barry et al., 2003
Families faced greater caps on the number of outpatient visits or inpatient days covered annually for MH/SUD treatment compared with non-MH/SUD medical services.
“Families faced greater caps on the number of outpatient visits or inpatient days covered annually for MH/SUD treatment compared with non-MH/SUD medical services.6,7”
From Parity and Out-of-Pocket Spending for Children With High Mental Health or Substance Abuse Expenditures (2013) · cites this paper as [6]
Historically, high out-of-pocket spending for a child's MH/SUD treatment has been due in part to benefit limits imposed by health plans.
“Historically, high OOP spending for a child’s MH/SUD treatment has been due in part to benefit limits imposed by health plans.”
From Parity and Out-of-Pocket Spending for Children With High Mental Health or Substance Abuse Expenditures (2013) · cites this paper as [6]
When families accessed MH/SUD services for their children, they were required to pay higher coinsurance amounts for MH/SUD services than for non-MH/SUD medical services.
“When families accessed MH/SUD services for their children, they were required to pay higher coinsurance amounts (ie, copays) for MH/SUD services than for non-MH/SUD medical services.”
From Parity and Out-of-Pocket Spending for Children With High Mental Health or Substance Abuse Expenditures (2013) · cites this paper as [6]
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- Authors
- Barry, C. L., Gabel, J. R., Frank, R. G., Hawkins, S., Whitmore, H. H., & Pickreign, J. D.
- Affiliations
- Harvard University (US)
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2003-09
- Volume
- 22
- Issue
- 5
- Pages
- 127-137
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- OpenAlex
- W2170276700
- Cited by
- 64
- References
- 12
- Citations by year
- 2024: 1 · 2022: 1 · 2019: 4 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 4
- FWCI
- 10.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (T32 MH19733-08, T32MH019733)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
- Keywords
- mental health coverage, employer-sponsored health insurance, mental health parity, health insurance law, mental health service delivery, health insurance premiums
- MeSH terms
- Health Benefit Plans, Employee, Humans, Insurance, Psychiatric, Managed Care Programs, Mental Health Services, Psychiatric Department, Hospital, Psychotropic Drugs, United States, Insurance Coverage, Health Care Surveys
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