Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.107
Filtrar
1.
Health Aff (Millwood) ; 41(7): 1023-1025, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35787083

RESUMO

Phantom networks are but one of many barriers to realizing access to mental health services. The term phantom networks refers to the misleading practice of listing providers as members of a network when they are not actually accepting patients. Inaccurate information on provider availability impedes the implementation of reforms that are designed to improve health insurance coverage of mental health treatment. Some other barriers to improving access to mental health services include low reimbursement rates from Medicaid, hesitancy of psychiatrists and psychologists to participate in networks, and practices of some managed care networks that require prior approval of mental health services such as psychiatric hospitalization. Phantom networks and these other barriers stand in the way of patients finding providers to help them at a time of need for treatment and support.


Assuntos
Seguro Psiquiátrico , Serviços de Saúde Mental , Humanos , Programas de Assistência Gerenciada , Medicaid , Autorização Prévia , Estados Unidos
2.
Psychiatr Serv ; 73(3): 265-270, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34320828

RESUMO

OBJECTIVE: This article describes policy surveillance methodology used to track changes in the comprehensiveness of state mental health insurance laws over 23 years, resulting in a data set that supports legal epidemiology studies measuring effects of these laws on mental health outcomes. METHODS: Structured policy surveillance methods, including a coding protocol, blind coding of laws in 10% of states, and consensus meetings, were used to track changes in state laws from 1997 through 2019-2020. The legal database Westlaw was used to identify relevant statutes. The legal coding instrument included six questions across four themes: parity, mandated coverage, definitions of mental health conditions, and enforcement-compliance. Points (range 0-7) were assigned to reflect the laws' comprehensiveness and aid interpretation of changes over time. RESULTS: The search resulted in 147 coding time periods across 51 jurisdictions (50 states, District of Columbia). Intercoder consensus rates increased from 89% to 100% in the final round of blinded duplicate coding. Since 1997, average comprehensiveness scores increased from 1.31 to 3.82. In 1997, 41% of jurisdictions had a parity law, 28% mandated coverage, 31% defined mental health conditions, and 8% required state agency enforcement. In 2019-2020, 94% of jurisdictions had a parity law, 63% mandated coverage, 75% defined mental health conditions, and 29% required state enforcement efforts. CONCLUSIONS: Comprehensiveness of state mental health insurance laws increased from 1997 through 2019-2020. The State Mental Health Insurance Laws Dataset will enable evaluation research on effects of comprehensive legislation and cumulative impact.


Assuntos
Seguro Psiquiátrico , Transtornos Mentais , District of Columbia , Humanos , Seguro Saúde , Epidemiologia Legal , Governo Estadual , Estados Unidos
3.
Med Care ; 59(10): 939-946, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34369459

RESUMO

BACKGROUND: Mental health insurance laws are intended to improve access to needed treatments and prevent discrimination in coverage for mental health conditions and other medical conditions. OBJECTIVES: The aim was to estimate the impact of these policies on mental health treatment utilization in a nationally representative longitudinal sample of youth followed through adulthood. METHODS: We used data from the 1997 National Longitudinal Survey of Youth and the Mental Health Insurance Laws data set. We specified a zero-inflated negative binomial regression model to estimate the relationship between mental health treatment utilization and law exposure while controlling for other explanatory variables. RESULTS: We found that the number of mental health treatment visits declined as cumulative exposure to mental health insurance legislation increased; a 10 unit (or 10.3%) increase in the law exposure strength resulted in a 4% decline in the number of mental health visits. We also found that state mental health insurance laws are associated with reducing mental health treatments and disparities within at-risk subgroups. CONCLUSIONS: Prolonged exposure to comprehensive mental health laws across a person's childhood and adolescence may reduce the demand for mental health visitations in adulthood, hence, reducing the burden on the payors and consumers. Further, as the exposure to the mental health law strengthened, the gap between at-risk subgroups was narrowed or eliminated at the highest policy exposure levels.


Assuntos
Seguro Psiquiátrico/legislação & jurisprudência , Transtornos Mentais/terapia , Adolescente , Adulto , Feminino , Humanos , Masculino , Saúde Mental , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
5.
J Nerv Ment Dis ; 208(7): 566-573, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32604163

RESUMO

This study examined opinions of American psychiatrists regarding prior authorization (PA) requirements for third-party payer coverage of medications and quantified perceived impact of these requirements on clinical practice. One thousand selected psychiatrist members of the American Psychiatric Association were invited to participate in a survey. Response rate was 33.1%. Respondents predominantly believed the obligation to obtain PA reduces job satisfaction and negatively impacts patient care. A total of 59.9% of respondents reported employing either diagnosis modification or falsification of previous medication trials at least occasionally in order to obtain PA. A total of 66.6% refrained at least occasionally from prescribing preferred medications due to PA requirement or expectation of one. On multivariate analysis, risk factors for refraining at higher frequency included seeing 300 or more patients in the previous 3 months, engaging more frequently in diagnosis modification, and reporting increased perception that obtaining PA reduces time for patient care.


Assuntos
Seguro de Serviços Farmacêuticos/economia , Satisfação no Emprego , Autorização Prévia/organização & administração , Psiquiatria/estatística & dados numéricos , Psicotrópicos/economia , Adulto , Idoso , Honorários Farmacêuticos , Feminino , Gastos em Saúde/tendências , Humanos , Seguro Psiquiátrico/economia , Modelos Logísticos , Masculino , Medicaid , Pessoa de Meia-Idade , Análise Multivariada , Autorização Prévia/economia , Psiquiatria/organização & administração , Psicotrópicos/uso terapêutico , Inquéritos e Questionários , Estados Unidos
6.
Health Econ Policy Law ; 15(2): 173-195, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-30309399

RESUMO

Parity in coverage for mental health services has been a longstanding policy aim at the state and federal levels and is a regulatory feature of the Affordable Care Act. Despite the importance and legislative effort involved in these policies, evaluations of their effects on patients yield mixed results. I leverage the Employee Retirement Income Security Act and unique claims-level data that includes information on employers' self-insurance status to shed new light in this area after the implementation of two state parity laws in 2007 and federal parity a few years later. My empirics reveal evidence of strategic avoidance on behalf of insurers in both states prior to the passage of state parity, as well as positive increases in mental health care utilization after parity laws are implemented - but context matters. Policy heterogeneity across states and strategic behaviors by employers and commercial insurers substantively shape the benefits that ultimately flow to patients. Insights from this research have broad relevance to ongoing health policy debates, particularly as states retain great discretion over many health coverage decisions and as federal policy continues to evolve.


Assuntos
Seguradoras , Seguro Saúde/legislação & jurisprudência , Seguro Psiquiátrico/legislação & jurisprudência , Serviços de Saúde Mental , Custos de Saúde para o Empregador , Política de Saúde , Humanos , Cobertura do Seguro/legislação & jurisprudência , Patient Protection and Affordable Care Act/legislação & jurisprudência , Estados Unidos
7.
Psychiatr Serv ; 70(4): 329-332, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30691383

RESUMO

OBJECTIVE: Children and adolescents with diagnosed mental disorders may require developmentally tailored interventions. However, little is known about the difference in mental health treatment utilization among children by age group and health insurance coverage. METHODS: Using the 2016 MarketScan database, the study examined treatment utilization patterns by health insurance coverage (private and Medicaid) and developmental age group (preschool-age children, ages 3-5; young children, ages 6-11; and adolescents, ages 12-17). RESULTS: Psychiatric medication only was the most common form of treatment utilization among all children, regardless of developmental age group or insurance coverage. Specifically, psychiatric medication only was received by 38% of preschool-aged children with Medicaid and 42% of those with private insurance, 43% of young children with Medicaid and 39% of those with private insurance, and 55% of adolescents with Medicaid and 49% of those with private insurance. CONCLUSIONS: Given that evidence-based practices suggest that combined treatment with psychiatric medications and psychotherapy may be the recommended treatment, the study's findings raise potential concerns about the high use of medication-only treatment.


Assuntos
Cobertura do Seguro/estatística & dados numéricos , Seguro Psiquiátrico/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Masculino , Psicoterapia/métodos , Psicotrópicos/uso terapêutico , Estados Unidos
8.
Adm Policy Ment Health ; 46(3): 334-351, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30604005

RESUMO

Policies have potential to help families obtain behavioral healthcare for their children, but little is known about evidence for specific policy approaches. We reviewed evaluations of select policy levers to promote accessibility, affordability, acceptability, availability, or utilization of children's mental and behavioral health services. Twenty articles met inclusion criteria. Location-based policy levers (school-based services and integrated care models) were associated with higher utilization and acceptability, with mixed evidence on accessibility. Studies of insurance-based levers (mental health parity and public insurance) provided some evidence for affordability outcomes. We found no eligible studies of workforce development or telehealth policy levers, or of availability outcomes.


Assuntos
Acesso aos Serviços de Saúde/organização & administração , Serviços de Saúde Mental/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde , Políticas , Criança , Pré-Escolar , Humanos , Cobertura do Seguro/estatística & dados numéricos , Seguro Psiquiátrico/estatística & dados numéricos , Assistência Médica/estatística & dados numéricos , Fatores Socioeconômicos , Estados Unidos
9.
Adm Policy Ment Health ; 46(2): 175-187, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30367297

RESUMO

This qualitative study draws on a photo-elicitation method ("PhotoVoice") and semi-structured interviews to examine the key areas stakeholders (30 young women between the ages of 18 and 35 in eating disorder recovery) identify as meaningful venues of policy-based change. Photography and the accompanying narratives capturing personally-meaningful social, cultural, and systemic influences on recovery were shared with the research team. Photographs and interviews were examined for policy implications using thematic analysis, and six areas of improvement emerged: media, healthcare practice and access, health insurance reform, education, objectification of the female body, and mental health stigma. Implications for reform are discussed.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Acesso aos Serviços de Saúde/organização & administração , Serviços de Saúde Mental/organização & administração , Adolescente , Adulto , Imagem Corporal/psicologia , Feminino , Humanos , Seguro Psiquiátrico , Relações Interpessoais , Entrevistas como Assunto , Educação de Pacientes como Assunto/organização & administração , Fotografação , Pesquisa Qualitativa , Estigma Social , Adulto Jovem
10.
J Ment Health Policy Econ ; 22(4): 151-154, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32058978

RESUMO

INTRODUCTION: The authors are health scientist administrators at the National Institute of Mental Health (NIMH). The mission of NIMH is "to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure." As part of its portfolio, NIMH supports research on mental health economics, and mental health services research. METHOD: In this perspective article, the authors comment on two papers presented at the NIMH-sponsored Mental Health Services Research Conference in 2018 and subsequently published in the September 2019 issue of the Journal of Mental Health Policy and Economics. Two important areas are highlighted in this review: (i) the impact of insurance and labor markets on the delivery of high-quality mental health services, and (ii) the need for advancements in method development and design in future studies. DISCUSSION: The complexity of health insurance markets created some unintended consequence of the mental health insurance parity legislation. Mental health provider shortages in local labor markets are a barrier to successful implementation and sustainment of innovative and evidence-based mental health service-delivery models for people with serious mental illness. IMPLICATIONS FOR RESEARCH: Data-capture techniques that seamlessly integrate insurance claims with clinical outcomes (e.g., from electronic health records) will better equip health economists and other end-users with rigorous research findings to inform public health policy and practice recommendations. Despite early signals of success, larger sample sizes and more rigorous research designs are needed to refine predictive models of functional outcomes of evidence-based service-delivery models (e.g., coordinated specialty care model including supported education, and supported employment) for people with first-episode psychosis.


Assuntos
Seguro Psiquiátrico , Transtornos Mentais/terapia , Serviços de Saúde Mental , Atenção à Saúde , Humanos , National Institute of Mental Health (U.S.) , Qualidade da Assistência à Saúde , Estados Unidos
11.
Health Aff (Millwood) ; 37(7): 1153-1159, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29985686

RESUMO

As of January 1, 2014, the Affordable Care Act designated mental health and substance use services as an essential health benefit in Marketplace plans and extended parity protections to the individual and small-group markets. We analyzed documents for seventy-eight individual and small-group plans in 2014 (after parity provisions took effect) and sixty comparison plans in 2013 (the year before parity provisions took effect) to understand the degree to which coverage for mental health and substance use care improved relative to medical/surgical benefits. The results suggest that plan issuers did what the provisions required them to do. Although in 2013 a lower proportion of plans covered mental health or substance use care, compared to medical/surgical care, in 2014 the proportions were the same. If essential health benefit requirements were to be removed and mental health and substance use coverage becomes similar to that in 2013, as many as 20 percent of the plans in our sample would not cover these conditions. To determine whether increases in behavioral health coverage will result in improved access to behavioral health services requires complementary data on the size of provider networks and use of services.


Assuntos
Acesso aos Serviços de Saúde/legislação & jurisprudência , Benefícios do Seguro/legislação & jurisprudência , Cobertura do Seguro/legislação & jurisprudência , Seguro Psiquiátrico/legislação & jurisprudência , Serviços de Saúde Mental/estatística & dados numéricos , Patient Protection and Affordable Care Act/normas , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Acesso aos Serviços de Saúde/economia , Humanos , Benefícios do Seguro/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Seguro Psiquiátrico/economia , Transtornos Mentais/economia , Transtornos Mentais/terapia , Serviços de Saúde Mental/legislação & jurisprudência , Patient Protection and Affordable Care Act/economia , Cobertura de Condição Pré-Existente/economia , Cobertura de Condição Pré-Existente/legislação & jurisprudência , Transtornos Relacionados ao Uso de Substâncias/economia , Estados Unidos
12.
Psychiatr Serv ; 69(9): 1036-1039, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-29921189

RESUMO

OBJECTIVE: This study examined trends in hospitalizations of youths for behavioral health conditions in acute care hospital nonpsychiatric beds, acute care hospital psychiatric and detoxification beds, and specialty psychiatric hospitals. METHODS: Using data on hospitalizations for behavioral health conditions in 2009 (N=21,805) and 2014 (N=27,550) from the MarketScan Commercial Claims and Encounters database, this study examined the percentage of youths (ages two to 18) with one or more hospitalizations, by demographic characteristic and bed type, and the behavioral health diagnoses for which patients were hospitalized. RESULTS: The greatest increase in hospitalizations of youths occurred in acute care hospital psychiatric and detoxification beds. The percentage of hospitalizations for suicidal ideation or self-harm injuries increased by 17.8 (N=526) to 30.0 (N=1,249) percentage points, depending on bed type. CONCLUSIONS: The continued trend of rising hospitalizations of youths is consistent with recent studies showing a doubling of hospitalizations of youths for suicide and self-harm.


Assuntos
Serviços de Saúde/estatística & dados numéricos , Hospitalização/tendências , Pacientes Internados/estatística & dados numéricos , Comportamento Autodestrutivo/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Distribuição por Idade , Criança , Pré-Escolar , Feminino , Humanos , Cobertura do Seguro , Seguro Psiquiátrico , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Setor Privado , Estudos Retrospectivos , Distribuição por Sexo , Estados Unidos/epidemiologia
13.
Psychiatr Clin North Am ; 41(2): 193-205, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29739520

RESUMO

Psychodynamic treatment provides benefits for patients with personality disorders, chronic depressive and anxiety disorders, and chronic complex disorders, and its intensity and duration have independent positive effects. Obstacles to its provision include a bias privileging brief treatments, especially cognitive behavior therapy, seen as a gold standard of treatment, despite difficulties with the design of, and ability to generalize from, its supporting research and the diagnostic nosology of the illnesses studied. Another obstacle lies in insurance company protocols that violate the mandate for mental health parity and focus on conserving insurers' costs rather than the provision of optimum treatment to patients.


Assuntos
Transtornos de Ansiedade/terapia , Transtorno Depressivo/terapia , Transtornos da Personalidade/terapia , Psicoterapia Psicodinâmica/métodos , Terapia Cognitivo-Comportamental/métodos , Planos de Assistência de Saúde para Empregados/economia , Humanos , Seguro Psiquiátrico/economia , Fatores de Tempo
14.
Psychiatr Pol ; 52(1): 143-156, 2018 Feb 28.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-29704421

RESUMO

OBJECTIVES: The main objective of the study was to verify the hypothesis about the high growth rate of expenditure on the provision of mental health in the past few years. High dynamics of the expenditure increase will result in the development of a model of community psychiatry and a gradual move away from the hospital psychiatric treatment towards mental health care in the open system, including the community one. METHODS: This research is based on data on the implementation of services for mental health care in the framework of agreements with the National Health Fund, which has been collected in the NFZ IT system. Some information is from 2010, which was adopted as the base date for the implementation of the principles of the National Mental Health Program in 2011. The data from the implementation of individual benefits in 2013 were used for the comparison. In addition, other selected organizational, economic and financial elements of the psychiatric care system were analyzed. RESULTS: In 2013, compared to 2010, increased the number of mental health care organizations: outpatient mental health clinics (an increase of 37 clinics), outpatient mental health day hospital wards (an increase of 25 wards) and community psychiatric treatment teams (an increase of 74 teams). The largest increase in the value of contracts (approx. 150%) was related to community treatment teams. CONCLUSIONS: Between 2010 and 2013 there was an increase in the value of cleared contracts in psychiatric care, in general and in each of the three forms of psychiatric care (i.e., in day wards, outpatient mental health clinics and in community teams). The highest increase in investments included community treatment teams, to a lesser extent day wards and outpatient clinics. The adopted organizational, economic and financial solutions in the mental health care system are in line with the objectives of the National Mental Health Program, including the assumed structure of Mental Health Centers.


Assuntos
Serviços Comunitários de Saúde Mental/economia , Necessidades e Demandas de Serviços de Saúde/economia , Seguro Psiquiátrico/economia , Transtornos Mentais/economia , Saúde Mental/economia , Serviços Comunitários de Saúde Mental/organização & administração , Acesso aos Serviços de Saúde/economia , Humanos , Transtornos Mentais/terapia , Saúde Mental/estatística & dados numéricos , Polônia , Unidade Hospitalar de Psiquiatria/economia
15.
Adm Policy Ment Health ; 45(5): 731-740, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29476292

RESUMO

There is increasing recognition that some preschool-aged children suffer from mental health conditions, but little is known about the treatment they receive. Using the 2014 MarketScan Commercial Claims and Encounters database (N = 1,987,759) the study finds that only a small proportion of preschool-aged children receive any behavioral interventions, including psychotherapy, in conjunction with having a filled psychiatric prescription. Nearly all of the preschool-aged children who had psychotropic prescriptions filled had no other claims for treatment, and among those children who had prescriptions for psychotropic medication filled, the vast majority did not have a mental health diagnosis on a claim.


Assuntos
Cobertura do Seguro/estatística & dados numéricos , Seguro Psiquiátrico/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Sintomas Comportamentais , Pré-Escolar , Feminino , Humanos , Lactente , Revisão da Utilização de Seguros , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/terapia , Psicoterapia/métodos , Psicotrópicos/uso terapêutico , Estados Unidos
16.
Annu Rev Public Health ; 39: 421-435, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29328871

RESUMO

The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 changed the landscape of mental health and substance use disorder coverage in the United States. The MHPAEA's comprehensiveness compared with past parity laws, including its extension of parity to plan management strategies, the so-called nonquantitative treatment limitations (NQTL), led to significant improvements in mental health care coverage. In this article, we review the history of this landmark legislation and its recent expansions to new populations, describe past research on the effects of this and other mental health/substance use disorder parity laws, and describe some directions for future research, including NQTL compliance issues, effects of parity on individuals with severe mental illness, and measurement of benefits other than mental health care use.


Assuntos
Disparidades em Assistência à Saúde/organização & administração , Cobertura do Seguro/legislação & jurisprudência , Seguro Psiquiátrico/legislação & jurisprudência , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Disparidades em Assistência à Saúde/normas , Humanos , Serviços de Saúde Mental/normas , Formulação de Políticas , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados Unidos
17.
Manag Care ; 27(1): 6-8, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29369760
18.
Manag Care ; 27(1): 20-22, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29369765

RESUMO

Demand for mental health services outstrips the supply of psychiatrists. Aggravating the situation: Many psychiatrists don't take insurance. Nurse practitioners and physician assistants are beginning to fill the gap.


Assuntos
Serviços de Saúde Mental , Profissionais de Enfermagem/provisão & distribuição , Assistentes Médicos/provisão & distribuição , Médicos/provisão & distribuição , Acesso aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Seguro Psiquiátrico , Estados Unidos , Recursos Humanos
19.
Manag Care ; 27(1): 23-27, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29369766

RESUMO

Insurers are playing "small ball" and not showing leadership, says the former congressman. And some "spin-dry" inpatient providers are doing more harm than good in combating the opioid epidemic. Meanwhile, Kennedy, who chronicled his own harrowing mental health and addiction struggles in a 2015 memoir, says he has been sober for more than six years.


Assuntos
Cobertura do Seguro/legislação & jurisprudência , Seguro Psiquiátrico/legislação & jurisprudência , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/legislação & jurisprudência , Transtornos Relacionados ao Uso de Substâncias/terapia , Disparidades em Assistência à Saúde , Humanos , Política , Justiça Social , Estados Unidos
20.
Health Serv Res ; 53(1): 366-388, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-27943277

RESUMO

OBJECTIVE: Did mental health cost-sharing decrease following implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA)? DATA SOURCE: Specialty mental health copayments, coinsurance, and deductibles, 2008-2013, were obtained from benefits databases for "carve-in" plans from a national commercial managed behavioral health organization. STUDY DESIGN: Bivariate and regression-adjusted analyses compare the probability of use and (conditional) level of cost-sharing pre- and postparity. An interaction term is added to compare differential levels of pre- and postparity cost-sharing changes for plans that were and were not already at parity pre-MHPAEA. FINDINGS: Controlling for employer/plan characteristics, MHPAEA is associated with higher intermediate care copayments ($15.9) but lower outpatient ($2.6) copayments among in-network-only plans. Among plans with in- and out-of-network benefits, MHPAEA is associated with lower inpatient ($23.2) and outpatient ($2.5) copayments, but increases in inpatient and intermediate in-network and out-of-network coinsurance (about 1 percentage point). Among the few plans not at parity pre-MHPAEA, changes in use and level of cost-sharing associated with MHPAEA were more dramatic. CONCLUSION: Mixed evidence that MHPAEA led to more generous mental health benefits may stem from the finding that many plans were already at parity pre-MHPAEA. Future policy focus in mental health may shift to slowing growth in cost-sharing for all health services.


Assuntos
Dedutíveis e Cosseguros/estatística & dados numéricos , Planos de Assistência de Saúde para Empregados/economia , Cobertura do Seguro/economia , Seguro Psiquiátrico/economia , Serviços de Saúde Mental/economia , Planos de Assistência de Saúde para Empregados/legislação & jurisprudência , Gastos em Saúde , Humanos , Transtornos Mentais/terapia , Serviços de Saúde Mental/legislação & jurisprudência , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...