This Web site is a component of the SAMHSA Health Information Network
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Organization & FinancingBibliography of Materials Related To Behavioral Health Insurance Parity: Selected Articles and ReportsACCESS, COVERAGE, AND UTILIZATION OF BEHAVIORAL HEALTH BENEFITS Behavioral Health Benefits in Employer-Sponsored Health Plans, 1997 This journal article describes mental health and substance abuse (MH/SA) services coverage, limits on MH/SA benefits, and differences by plan type and employer insurance status. Researchers from the Substance Abuse and Mental Health Services Administration (SAMHSA) worked with employer survey experts from William A. Mercer, Inc. to analyze questions regarding behavioral health benefits from the Mercer/Foster Higgins National Survey of Employer-Sponsored Health Plans. Results indicate that, although three-quarters or more of employer-sponsored health plans continue to place greater restrictions on behavioral health coverage than on general medical coverage, the proportion of plans covering nontraditional behavioral health services has increased and the use of special limits for mental health benefits has declined. Published in Health Affairs, Vol. 18, No.2, pp. 67-78 (March/April, 1999). To order: Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, Tel: (800)765-7514 or (301)656-7401, Fax: (301)654-2845. Covering Mental Health and Substance Abuse Services This journal article presents data from two investigations of mental health and substance abuse services in health employer plans and health maintenance organizations (HMOs). It provides background information on the Mental Health Parity Act, explains the potential effects of this law, describes the results of a panel study conducted by Foster Higgins on employer health plans and compares these data to the results of other industry surveys conducted annually by the American Association of Health Plans (AAHP). The authors demonstrate how the results of the two studies jointly add to our knowledge on the use of limits on mental health and substance abuse benefits. Published in Health Affairs, Vol. 16, No. 4 , pp. 120-126 (July/August, 1997). To order: Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, Tel: (800)765-7514 or (301)656-7401, Fax: (301)654-2845. Health Care Plan Design and Cost Trends - 1988 through 1998 This 23-page report updates a 1998 report analyzing trends in the proportion of employer health care dollars spent on behavioral health care. The report finds that: (1) the total value of employer-provided health plan benefits, in constant dollars, decreased by 14.2 percent over the last 11 years; (2) behavioral health benefits have become more limited; and (3) per-visit dollar limits and annual dollar limits for behavioral health care have not accommodated increased inflation. An appendix includes descriptions of typical behavioral health care plans. Published by the Hay Group ( April, 1999). This publication is available on the National Association of Psychiatric Health Systems and the Association of Behavioral Group Practices website: http://www.naphs.org Mental Health Insurance in the 1990s: Are Employers Offering Less to More? This journal article examines trends in behavioral health care coverage in employer-sponsored plans between 1991 and 1995, before enactment of the 1996 parity legislation. It asserts that, although the provision of mental health insurance benefits through employer-sponsored health plans has received increasing attention with the passage of the Mental Health Parity Act of 1996, this legislation is but one of several factors contributing to a restructuring of mental health benefits in the 1990s. The authors assert that market forces, such as the move to managed care and employers' growing tendency to subcontract out (carve out) the administration of their mental health benefits, are leading to profound changes in the nature of employer-sponsored mental health coverage. The authors conclude that more insured workers in the 1990s have coverage for mental health services but the depth of their benefits appear to be shrinking. Published in Health Affairs, Vol. 17, No. 3 , pp. 201-208 (May/June, 1998). To order: Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, Tel: (800)765-7514 or (301)656-7401, Fax: (301)654-2845. Substance Abuse Service Utilization Under Managed Care This journal article examines substance abuse service utilization in HMOs versus carve-out plans. The authors examine claims for one large Midwestern employer for substance abuse services and compares them to HMO claims information. The authors concluded that utilization of inpatient and outpatient services decreased under the carve-out, but intermediate service utilization, such as residential treatment, recovery homes, partial hospitalization, day treatment programs and intensive outpatient programs, increased dramatically. Costs per unit of service appear to have decreased under the carve-out for inpatient, intermediate, and outpatient services. The authors note that the pattern of these changes is different from that seen for mental health services, suggesting that different factors may be relevant to substance abuse services compared to mental health services. Published in Journal of Behavioral Health Services Research, Vol.26, No. 4 (May, 1999). To order: Research Center on Managed Care for Psychiatric Disorders, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90024-6505, Tel: (310)794-3725, Fax: (310)794-3724. PARITY IMPLEMENTATION ISSUES This 11-page report provides an overview of changes in mental health care delivery during the past few years and encourages human resource managers to carefully design mental health benefits required under the Mental Health Parity Act of 1996. The report cautions human resource managers about negative consequences of overly restrictive managed mental health benefits, and asserts that ineffective treatment and poor outcomes result from inappropriate plan design and arbitrary interference with needed care for patients with mental illness. The report outlines legal requirements under the Act and addresses additional compliance issues that human resource managers should consider. Insurance Carrier/Health Plan Views on Impact of New Hampshire Parity Legislation This 7-page report explores implementation and cost implications of New Hampshire’s 1994 adoption of legislation mandating insurance parity for selected mental illnesses. Information gathered during interviews with insurance carriers and health plans that do business in the state of New Hampshire indicate that premium increases have been minimal. Insurance carriers and health plans also responded to questions regarding service utilization, control procedures, and the extent to which mental health parity arose as an issue in negotiations or complaints between employers and consumers. Published by The Lewin Group, Inc. (April, 1997). To order, contact The National Alliance on Mental Illness (NAMI), Colonial Place Three, 2107 Wilson Blvd., Suite 300, Arlington, VA 22201-3042, Tel: (703)524-7600, Fax: (703)524-9094. Analysis of the Mental Health Parity Act of 1996, P.L. 104-204 This 48-page report examines the impact of selected provisions in the Mental Health Parity Act of 1996 and proposed regulations, with special emphasis on the one-percent cost exemption included in the law. The report discusses the direct and indirect effects of the law; reviews published estimates of the impact of the law on benefit costs; estimates the number of health plans eligible for the one-percent cost exemption and/or small employer exemption; and estimates the number of health plans, firms, policyholders, and covered lives that would be affected. This report also discusses anticipated benefit design changes and other health plan responses to the federal parity law. Mental Health and Substance Abuse Benefits in Carve-Out Plans and the Mental Health
Parity Act of 1996 This journal article analyzes the benefit designs of 4,000 behavioral health carve-out plans and discusses the Mental Health Parity Act of 1996 as an opportunity to simplify benefit designs. The authors assert that many behavioral health benefits were designed to contain costs and control adverse selection in an unmanaged fee-for-service environment, and that these benefit designs -- which include deductibles, limits, and other demand-side cost-sharing mechanisms -- are inconsistent and unnecessarily complex in managed care plans. Published in Journal of Health Care Finance, Vol. 24, No. 3, pp. 82-92 (1998). To order: Aspen Publishers, Inc., 7210 Thomas McKinney Circle, Frederick, MD 21704, Tel: (800)234-1660, Fax: (800)638-8437 or (301)695-7931. Mental Health Parity Compliance: Legal Requirements and Benefit Design Options This journal article defines plans which are potentially exempt from the Mental Health Parity Act of 1996; examines the benefits of complying; and notes the risks of "opting out" under the law. The article notes that group health plans without annual or lifetime dollar limits for medical or surgical benefits may not impose such limits for mental health benefits. Published in Behavioral Healthcare Tomorrow, Vol. 6, No. 4 pp. 35-38 (August, 1997). To order: Manisses Communications Group, Inc., P.O. Box 9758, Providence, RI 02940-9758, Tel: (800)333-7771 or (401)831-6020, Fax: (401)861-6370. Case Studies: A Guide to Implementing Parity for Mental Illness This 12-page report provides three case studies of employers who have successfully implemented mental health parity. The report describes the employers’ motivations in providing mental health parity, summarizes costs and cost savings achieved through implementation of parity, and offers suggestions for successful implementation. Employers profiled in these case studies are Prime Tanning, Inc., Lubrizol Corporation, and Black and Decker Corporation. Published by William M. Mercer, Inc. (1998). To order, contact The National Alliance on Mental Illness (NAMI), Colonial Place Three, 2107 Wilson Blvd., Suite 300, Arlington, VA 22203-3754, Tel: (703)524-7600, Fax; (703)524-9094. Annual and Lifetime Limits to Mental Health Care Thwart Intent of Parity Act This journal article discusses preliminary evidence indicating that a national law aimed at eliminating discrimination toward persons with mental illness in health care insurance plans appears to be backfiring. Although the Mental Health Parity Act of 1996 was fully implemented in January of 1998, health care insurers are replacing the dollar limits on mental health care services with annual and lifetime restrictions on the number of visits to a mental health care provider that would be covered, which is effectively "attempting to render a federal law worthless." Findings indicate that employers and health plans are finding legal ways to negate these steps by adjusting visit and co-payment limits. This journal article discusses legislative limits; whether benefits are, in fact, being enhanced; the use of ERISA as a shelter from state regulation; efforts to speak out by members of the congressional delegation; and other congressional actions. Published in Mental Health Economics,Vol. 2, No.4 (1998), a supplemental newsletter to Psychiatric Times by CME, Inc. To order: CME, Inc., 2801 McGaw Avenue, Irvine, CA 92614, Tel: (949)250-1008, Fax: (949)250-1245. LEGISLATIVE AND REGULATORY PERSPECTIVES This 9-page report discusses ways in which parity might affect each of four health care delivery systems in practice today. The report provides examples of ways in which employers might attempt to offset increased mental health costs, and demonstrates how additional costs associated with S.2031 would be reduced in plans with stronger managed care programs. An Actuarial Analysis of the Domenici-Wellstone Amendment to S.1028 "Health Insurance Reform Act" to Provide Parity for Mental Health Benefits Under Group and Individual
Insurance Plans This 22-page report asserts that mental health parity, as defined by the Domenici-Wellstone Amendment and proposed federal legislation, would result in net savings to insurance companies under group and individual insurance plans. Savings in the public sector, private sector, and the net national savings of the Domenici-Wellstone Amendment are illustrated in data charts. A discussion of how provider efficiencies allow cost-effective privatization of mental health is also provided. An Actuarial Analysis of Comprehensive Mental Health and Substance Abuse Parity and Other Options for Improved Coverages in the State of Vermont This 24-page report provides a detailed discussion and cost analysis of mental health and substance abuse parity proposals considered during the 1997 Vermont legislative session. The report includes a cost analysis of comprehensive parity, defined as coverage of insured mental health and substance abuse benefits on the same basis as medical care coverage. The report also provides parity cost estimates for: (1) mental health only; (2) mental health and substance abuse combined; and (3) other parity options in Vermont. Mental Health Parity Act Summary Developed by the Office of Managed Care, Center for Mental Health Services (CMHS) of the Substance Abuse Mental Health Services Administration (SAMHSA), this 5-page report provides a summary of the Mental Health Parity Act of 1996 (MHPA). The report includes a detailed summary of the law and provisions of the regulations. Published by the Center for Mental Health Services of the Substance Abuse Mental Health Services Administration Effects of the Mental Health Parity Act of 1996 Developed by the Office of Managed Care, Center for Mental Health Services (CMHS) of the Substance Abuse Mental Health Services Administration (SAMHSA), this 4-page report provides information on the effects of the federal Mental Health Parity Act of 1996 (MHPA), which became effective on January 1, 1998. The report provides an analysis based on data collected by the Mercer/Foster Higgins survey regarding employer health plans, including costs, strategic planning, and scope and limitations of health coverage. Analysis of State Mental Health and Substance Abuse Parity Legislation This 126-page report describes and compares behavioral health parity laws enacted by 12 states whose legislation goes beyond simple compliance with federal law. The 12 states are Arkansas, Colorado, Connecticut, Indiana, Maine, Maryland, Minnesota, New Hampshire, North Carolina, Rhode Island, Texas, and Vermont. Divided into three sections, the report: (1) addresses the policy context for parity; (2) offers a summary of state mental health parity mandates, including descriptions of legislation by state and comparison of state mandates; and (3) discusses implications for study design. Appendices include the text of the Mental Health Parity Act of 1996, mental health and substance abuse parity legislation by state, and state mental health and substance abuse mandates. Published by Mathematica Policy Research, Inc. (January 15, 1998). To order: Mathematica Policy Research, Inc., 600 Maryland Avenue, SW, Suite 550, Washington, DC 20024-2512, Tel: (202)484-9220, Fax: (202)863-1763. Premium Rate Estimates for a Mental Illness Parity Provision to S.1028, "The Health Insurance Reform Act of 1995" This 12-page report, prepared for the Coalition for Fairness in Mental Illness Coverage (American Managed Behavioral Healthcare Association, American Psychiatric Association, National Alliance for the Mentally Ill, National Association of Psychiatric Health Systems, and the National Mental Health Association), describes mental health parity provisions in S.1028 and estimates costs for commercial health insurance plans. The authors estimate that mental illness and substance abuse parity, as described in S.1028, would increase per capita health insurance premiums (including fee-for-service and managed care plans) by 3.9%. The report asserts that premium cost increases attributable to non-discriminatory coverage for treatment of mental illness would be lower in more aggressively managed delivery systems. The report provides implementation options to reduce or eliminate additional costs to health insurance plans. Appendices provide descriptions of assumptions and limitations and a summary of plan provisions of "typical" benefit plans. Published by Milliman & Robertson, Inc. (April, 1996). To order, contact the American Managed Behavioral Healthcare Association at www.ambha.org/Reports/cost.htm or 700 13th Street, NW, Suite 950, Washington, D.C. 20005, Tel: (202)434-4565, Fax: (202)434-4564. Publication order includes The Costs of Non-Discriminatory Health Insurance Coverage for Mental Illness by Milliman and Robertson for the Coalition for Fairness in Mental Illness Coverage. Mental Health Parity Act of 1996 (P.L. 104-204) The Mental Health Parity Act of 1996 (MHPA) amended the Public Health Service Act (PHSA) and the Employee Retirement Income Security Act of 1974 (ERISA) to provide for parity in the application of dollar limits on certain mental health benefits when limits are placed on medical and surgical benefits. Substantially similar provisions implementing MHPA were later added to the Internal Revenue Code of 1986 under the Taxpayer Relief Act of 1997. Health coverage is regulated, in part, by the Federal government, under ERISA and the PHS Act, and other Federal provisions including the Internal Revenue Code, and, in part, by the States. Interim Rules for Mental Health Parity The Interim Rules implementing the Mental Health Parity Act of 1996 were published in the December 22, 1997 Federal Register (Volume 62, Number 245, pp. 66931-66966). ECONOMIC COSTS AND SAVINGS OF PARITY This 81-page report presents the results of a critical study finding that full parity for mental health and substance abuse services in aggressively managed private health insurance plans would increase family insurance premiums less than one percent. The report includes a comprehensive literature review and notes that, although appropriate drug and alcohol treatment and mental health service programs improve lives and increase productivity, health insurance plans typically provide less coverage for mental health and substance abuse treatment than for physical health care intervention. The report also discusses state parity laws, provides case study reports from five states that have parity laws, and provides estimates of premium increases for full- and partial-parity options. Published by the Center for Mental Health Services, Office of Managed Care (March, 1998). To order: National Mental Health Information Center, P.O. Box 42557, Washington, DC 20015, Tel: 1-800-789-2647. (DHHS Publication Number: (SMA)98-3205) Issues in Mental Health Care Benefits: The Costs of Mental Health Parity This 15-page Issue Brief describes the current state of employment-based mental health benefits; reviews issues and existing research related to mental health parity; analyzes the effect of full mental health parity on the uninsured population; and addresses implications of the Mental Health Parity Act of 1996 on health plans and health insurers. Tables include data on the percentage of large employers that offer mental health and substance abuse benefits through a specialty preferred provider organization (PPO) or through an employee assistance program (EAP). Additional data includes typical plan provisions of hypothetical PPOs. Several charts estimate the annual change in average total health benefit costs for specific population groups. Published by the Employee Benefit Research Institute, Issue Brief No. 182 (February, 1997). To order: Employee Benefit Research Institute, 2121 K Street, NW, Suite 600, Washington, DC 20037, Tel: (202)659-0670, Fax: (202)775-6312. The Costs of Non-Discriminatory Health Insurance Coverage for Mental Illness This 14-page report presents premium rate estimates for mental health services contained in S.298, the "Equitable Health Care for Severe Mental Illness Act," and compares them to estimates contained in a 1996 report prepared by Watson Wyatt Worldwide for the Association of Private Pension and Welfare Plans. Findings indicate that the treatment of severe mental illness as required by S.298 would increase total per member per month premiums for a "typical" Preferred Provider Organization (PPO) plan by 2.5 percent. To implement parity provisions of S.298 in a "budget neutral" fashion, outpatient visit and prescription drug co-payments would increase by $5 (from a base of $10) to $15. Alternately, a plan could impose a calendar year deductible -- between $35 and $40 -- on all healthcare services in addition to existing cost sharing as described in the "typical" PPO plan. Published by Milliman & Robertson, Inc. (April, 1996). To order, contact the American Managed Behavioral Healthcare Association at www.ambha.org/Reports/cost.htm or 700 13th Street, NW, Suite 950, Washington, D.C. 20005, Tel: (202)434-4565, Fax: (202)434-4564. Publication order includes Premium Rate Estimates for a Mental Illness Parity Provision to S.1028, "The Health Insurance Reform Act of 1995" by Milliman and Robertson for the Coalition for Fairness in Mental Illness Coverage. Parity in Coverage of Mental Health Services in an Era of Managed Care: An Interim
Report to Congress This 43-page report responds to a request by the Senate Appropriations Committee regarding the costs of providing insurance parity for people with mental illnesses, particularly those that are "severe and clearly identifiable, diagnosable, and treatable." The report describes the activities of a special workgroup of the National Advisory Mental Health Council (NAMHC) in developing a new comparative empirical database that can form economic assumptions and models for estimating the financial impact of parity and managed care. Preliminary results indicate that the introduction of parity in combination with managed care results in lowered costs and lower premiums within the first year of parity implementation; the national introduction of parity in private health insurance will not have uniform effects across states; and a benefit design alone cannot necessarily assure access to mental health and substance abuse services in the presence of managed care. Published by the National Institute of Mental Health (April, 1997). To
order: NIMH Information Resources and Inquiries Branch, 6001 Executive Blvd.,
Room 8184, MSC 9663, Bethesda, MD 20892-9663, 301-443-4513, Fax:301-443-4279,
nimhinfo@nih.gov, http://www.nimh.nih.gov Mental Health/Medical Care Offsets: Opportunities for Managed Care This journal article explores whether increased access to mental health care would cause a compensatory reduction in the use of medical care services. The authors assert that some managed care firms could capture medical care costs savings by making mental health services more accessible to some patients. Such savings, or cost offsets, have been found following mental health treatment of distressed elderly medical inpatients, some patients as they develop major medical illnesses, primary care outpatients with multiple unexplained somatic complaints, and non-elderly adults with alcoholism. Published in Health Affairs, Vol.18, No.2 pp.79-90 (March/April, 1999). To order: Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, Tel: (800)765-7514 or (301)656-7401, Fax: (301)654-2845. How Expensive Is Unlimited Mental Health Care Coverage Under Managed Care? This report examines the costs, access, and intensity of mental health care under managed carve-out plans with generous coverage; compares the study’s assumptions to those used in other studies; and predicts the cost impact of the Mental Health Parity Act. Based on claims data from 1995-96 for 24 managed care carve-out plans, the authors conclude that costs are lower than projected in other studies due to reduced hospitalization rates, a relative shift to outpatient care, and reduced payments per service. The authors conclude that although concerns about costs have stifled many health reform proposals, policy decisions were often based on incorrect assumptions and outdated data that lead to dramatic overestimates, and that the cost consequences of improved coverage under managed care are relatively minor. Published in Journal of the American Medical Association, Vol. 278, pp.1553-1537 (November 12, 1997). To order: Research Center on Managed Care for Psychiatric Disorders, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90024-6505, Tel: (310)794-3725, Fax: (310)794-3724. How Expensive Are Unlimited Substance Abuse Benefits Under Managed Care? This journal article estimates the number of individuals affected by substance abuse coverage limitations and the likely cost implications of reducing or eliminating those limitations. The article examines claims during 1996-97 from 25 managed care plans with unlimited substance abuse benefits to determine which limits would have reduced services. The authors conclude that changing even stringent limits on annual substance abuse benefits has a small absolute effect on overall insurance costs under managed care, even though a large percentage of substance abuse patients would be affected. The report also asserts that removing an annual limit of $10,000 per year on substance abuse care increases insurance payments by about 6 cents per member per year. Published in Journal of Behavioral Health Services Research, Vol. 26, No.2, pp. 203-210 (1999). To order: Sage Publications, 2455 Teller Road, Thousand Oaks, CA 91320, Tel: (805)499-0721, Fax: (805)499-0871. GENERAL TOPICS IN PARITY This 8-page report explores cost-containment strategies for mental health benefits and presents examples of the move toward integration of mental health and primary health care. Topics include the economic cost of mental illness and substance abuse; cost containment; integrating primary and behavioral health care; the effects of parity on overall mental health costs; goals of a behavioral health plan; and related resources. Data tables provide information on monthly claims costs per person, by risk level and type of claim; annual utilization by risk level and type of claim; inpatient and outpatient limits for mental health and substance abuse benefits; and typical in-network and out-of-network coverage for substance abuse. This report also includes a list of goals for behavioral health benefits design. A Medical Benefits Special Report published by Panel Publishers (November, 1997). To order: Aspen Law and Business Reprints, Attn: Melissa Price, 1185 Avenue of the Americas, New York, NY 10036, Tel: (212)597-0311. Statement on Coverage for Mental Health and Substance Abuse Services This 5-page document provides Congressional testimony presented on behalf of the Washington Business Group on Health, which represents 200 major U.S. employers. The testimony describes knowledge gained by large employers and child and adolescent health professionals over the past decade about providing high quality cost effective mental health and substance abuse care. The testimony emphasizes the need for fundamental change in the financing and delivery of mental health services; outlines basic principles of health reform; offers system characteristics and a definition of the delivery system reform; and presents the critical elements of model reforms in mental health service delivery. To order: The Washington Business Group on Health, 777 North Capitol Street, Suite 800, Washington, DC 20002, Tel: (202)408-9320, Fax: (202)408-9332. The Politics and Economics of Mental Health 'Parity' Laws This journal article describes the economic forces that have traditionally limited coverage of mental health care, the political context for adoption of the Mental Health Parity Act of 1996, and the challenges of ensuring access to mental health care in today's managed care world. The article analyzes the rationale for adoption of federal and state parity laws and examines their likely impact in the era of managed care. The authors conclude that although such successes represent important political events, they may offer only small gains in the efficiency and fairness of insurance markets. Published in Health Affairs, Vol. 16, No. 1 , pp. 108-140 (July/August, 1997). To order: Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, Tel: (800)765-7514 or (301)656-7401, Fax: (301)654-2845. The Case for Parity in Mental Health Insurance Through A Single-Payer Plan This journal article provides a review of the literature on a two-tiered system of mental health coverage and argues for parity under a single-payer system as an egalitarian solution. A case is made for providing equal health insurance benefits for mental illness as compared to other medical conditions, and the author states that the stigmatization of mental health consumers is unacceptable on the grounds of equity, efficiency, and economy. Published by the International Association of Psychosocial Rehabilitation Services, Psychiatric Rehabilitation Journal, Vol. 20, No. 1, pp. 33-36 (Summer, 1996). To order: International Association of Psychosocial Rehabilitation Services, 10025 Governor Warfield Parkway, #301, Columbia, MD 21044-3357, Tel: (410)730-7190, Fax: (410)730-5965. Parity in Financing Mental Health Services: Managed Care Effect on Cost, Access and
Quality: An Interim Report to Congress by the National Advisory Mental Health Council Written as a follow-up to a 1997 report titled, "Parity in Coverage of Mental Health Services in an Era of Managed Care," this 112-page report provides current research-based knowledge about the impact of managed care on mental health services. Particular emphasis is placed on costs of mental health care under parity; access to mental health care; and quality of care. This report also identifies future directions for study, including systematic outcome data, evaluations of the State Children's Health Insurance Program (SCHIP), and research on the impact of managed care in Medicaid plans and on the relationship between the public and private mental health systems under diverse types of funding. Published by the National Institute of Mental Health (April, 1998). To order: NIMH Information Resources and Inquiries Branch, 6001 Executive Blvd., Room 8184, MSC 9663, Bethesda, MD 20892-9663, 301-443-4513, Fax:301-443-4279, nimhinfo@nih.gov, http://www.nimh.nih.gov Health Care Reform for Americans with Severe Mental Illnesses: Report of the National Advisory Mental Health Council This journal article responds to a request by the Senate Committee on Appropriations regarding (1) the cost of insurance coverage parity for severe mental illness; and (2) an assessment of the efficacy of treatment of severe mental illness. The article cites an extensive body of research evidence supporting insurance parity for severe mental illness. The article also asserts that greater access to treatments of demonstrated effectiveness will help individuals with severe mental illnesses function more productively. The article also provides background information on the nature of severe mental illness, prevalence of severe mental illness among adults and children, efficacy of many treatments for people with severe mental disorders, utilization of treatment services, funding sources for mental health care, and social costs and treatment costs. Published in American Journal of Psychiatry, Vol. 150, No. 10, pp. 1447-1465 (October, 1993), by the American Psychiatric Press. To order: NIMH Information Resources and Inquiries Branch, 6001 Executive Blvd., Room 8184, MSC 9663, Bethesda, MD 20892-9663, Tel: (301)-443-4513 Fax: (301)-443-4279, nimhinfo@nih.gov, http://www.nimh.nih.gov. Mental Health Parity: What Can it Accomplish in a Market Dominated by Managed Care? This 35-page comprehensive report describes the history of discriminatory insurance coverage for mental illness and the parity movement; identifies major barriers to analyzing and evaluating parity proposals; and summarizes a June, 1997 experts’ panel on mental health parity convened by the Milbank Memorial Fund and The National Alliance on Mental Illness. Other areas of emphasis include the promise and limitations of federally-mandated parity; costs of parity; and the future of parity. The report purports not to take policy positions, but to facilitate a reasoned discussion of alternatives. Published by the Milbank Memorial Fund (1998). To order: Milbank Memorial Fund, 645 Madison Avenue, New York, NY 10022, Tel: (212)355-8400, Fax: (212)355-8599. |
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