Cost sharing for substance abuse and mental health services in managed care plans

Medical Care Research and Review

Volumn 60, Issue 1, 2003, Pages 101-116

  Hodgkin, Dominic ^a   Horgan, Constance M ^a   Garnick, Deborah W ^a   Merrick, Elizabeth L ^a  

^a BRANDEIS UNIVERSITY   (United States)

Author keywords

Behavioral health; Benefits; Cost sharing; Health maintenance organizations; Managed care; Parity

Indexed keywords

ARTICLE; COMPARATIVE STUDY; COST; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HUMAN; LAW; MENTAL HEALTH SERVICE; OUTPATIENT; PARITY; PRIMARY MEDICAL CARE; SUBSTANCE ABUSE; UNITED STATES;

COST OF ILLNESS; COST SHARING; HEALTH CARE SURVEYS; HUMANS; MANAGED CARE PROGRAMS; MENTAL DISORDERS; MENTAL HEALTH SERVICES; SUBSTANCE-RELATED DISORDERS; UNITED STATES;

EID: 0037366677     PISSN: 10775587     EISSN: None     Source Type: Journal    
DOI: 10.1177/1077558702250248     Document Type: Article

References (35)

1. Buck, J. A., J. L. Teich, B. Umland, and M. Stein. 1999. Behavioral health benefits in employer-sponsored plans, 1997. Health Affairs 18 (2): 67-78.
2. Bureau of Labor Statistics. 1999. Employee benefits in medium and large private establishments, 1997. Bulletin 2517. Washington, DC: U.S. Department of Labor.
3. Frank, R. G., C. Koyanagi, and T. McGuire. 1997. The politics and economics of mental health "parity" laws. Health Affairs 16:108-19.
4. Frank, R. G., and T. G. McGuire. 2000. The economics of mental health. In Handbook of health economics, edited by A. Culyer and J. P. Newhouse. Amsterdam, the Netherlands: Elsevier Science BV.
5. -. 1986. A review of studies of the impact of insurance on the demand and utilization of specialty mental health services. Health Services Research 21:241-65.
6. General Accounting Office. 2000. Mental Health Parity Act: Despite new federal standards, mental health benefits remain limited. GAO/HEHS-00-95.
7. Gitterman, D. P., R. Sturm, R. L. Pacula, and R. M. Scheffler. 2001. Does the sunset of mental health parity really matter? Administration & Policy in Mental Health 28 (5): 353-69.
8. Gold, M., and R. Hurley. 1997. The role of managed care "products" in managed care plans. Inquiry 34: 29-37.
9. Grazier, K. L., and H. Pollack. 2000. Translating behavioral health services research into benefits policy. Medical Care Research and Review 57 (2): S53-S71.
10. Grembowski, D. E., et al. 2000. Measuring the "managedness" and covered benefits of health plans. Health Services Research 35 (3): 707-34.
11. Grob, G. 1991. From asylum to community. Princeton, NJ: Princeton University Press.
12. Hodgkin, D., C. M. Horgan, and D. W. Garnick. 1997. Make or buy: HMOs' contracting arrangements for mental health care. Administration and Policy in Mental Health 24 (4): 359-76.
13. Horgan, C. M. 1986. The demand for ambulatory mental health services from specialty providers. Health Services Research 21 (2): 291-320.
14. Horgan, C. M., et al. 2000. Substance abuse and mental health services in managed care organizations: Results from a nationwide study. Summary report to respondents, Brandeis University.
15. Jensen, G. A., K. Rost, R. D. P. Burton, and M. Bulycheva. 1998. Mental health insurance in the 1990s: Are employers offering less to more? Health Affairs 17 (3): 201-8.
16. Keeler, E. B., W. G. Manning, and K. Wells. 1989. The demand for episodes of mental health services. Journal of Health Economics 7:369-92.
17. Kemper, P., et al. 1996. The design of the community tracking study: A longitudinal study of health system change and its effects on people. Inquiry 33 (2): 195-206.
18. Ma, C. A., and T. G. McGuire. 2002. Network incentives in managed health care. Journal of Economics and Management Strategy 11 (1): 1-35.
19. Mechanic, D. 1999. Mental health and social policy: The emergence of managed care. Needham Heights, MA: Allyn & Bacon.
20. Mechanic, D., M. Schlesinger, and D. D. McAlpine. 1995. Management of mental health and substance abuse services: State of the art and early results. Milbank Quarterly 73 (1):19-55.
21. Mental Health Associates. 2001. Therapists' Insurer Profiling (TIP) Scale. Retrieved 31 January 2001 from http://www.mentalhealth-madison.com
22. Merrick, E. L., D. W. Garnick, C. M. Horgan, D. Goldin, D. Hodgkin, and M. Sciegaj. 2001. Benefits in behavioral health carve-out plans of Fortune 500 firms. Psychiatric Services 52:943-48.
23. New York Times. 2001. Nine million gaining upgraded benefit for mental care, 1 January.
24. Pacula, R. L., and R. Sturm. 2000. Mental health parity and employer-sponsored health insurance in 1999-2000: II. Copayments and coinsurance. Psychiatric Services 51 (12): 1487.
25. Peele, P. B., J. R. Lave, and Y. Xu. 1999. Benefit limits in managed behavioral health care: Do they matter? Journal of Behavioral Health Services and Research 26 (4): 430-41.
26. Pomerantz, J. M. 2000. Managed care's treatment of chronic and relapsing patients. Drug Benefit Trends 12 (11): 2BH-3BH.
27. Reuters Health. 2000. Three-tier copay plans grow in popularity. Retrieved 14 August 2000 from http://managedcare.medscape.com/reuters/prof/2000
28. Rice, T. 1998. Economics of health care reconsidered. Chicago: Health Administration Press.
29. Salkever, D., J. Shinogle, and H. Goldman. 1999. Mental health benefit limits and cost sharing under managed care: A national survey of employers. Psychiatric Services 50 (12):1631-33.
30. Shah, B. V., B. G. Barnwell, and G. S. Bieler. 1997. Sudaan user's manual: Release 7.5. Research Triangle Park, NC: Research Triangle Institute.
31. Simon, G. E., L. Grothaus, M. L. Durham, M. VonKorff, and C Pabiniak. 1996. Impact of visit copayments on outpatient mental health utilization by members of a health maintenance organization. American Journal of Psychiatry 153 (3): 331-38.
32. Sosin, M. R., and T. D'Aunno. 2001. The organization of substance abuse managed care. In Recent developments in alcoholism, edited by M. Galanter, 27-49. New York: Plenum Press.
33. Stein, B., M. Orlando, and R. Sturm. 2000. The effect of copayments on drug and alcohol treatment following inpatient detoxification under managed care. Psychiatric Services 51 (2): 195-98.
34. Sturm, R., and J. McCulloch. 1998. Mental health and substance abuse benefits in carve-out plans and the Mental Health Parity Act of 1996. Journal of Health Care Financing 24 (3): 82-92.
35. Zarkin, G., S. A. Garfinkel, F. J. Potter, and J. J. McNeill. 1995. Employment-based health insurance: Implications of the sampling unit for policy analysis. Inquiry 32:310-19.