The costs of mental health parity: Still an impediment?

Health Affairs

Volumn 25, Issue 3, 2006, Pages 623-634

  Barry, Colleen L ^a   Frank, Richard G ^b   McGuire, Thomas G ^b  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COST; COST CONTROL; ECONOMICS; HEALTH CARE COST; HEALTH INSURANCE; HUMAN; INSURANCE; MENTAL HEALTH SERVICE; PATIENT; REVIEW; SOCIAL JUSTICE; UNITED STATES;

COST CONTROL; COST SHARING; EMPLOYER HEALTH COSTS; HEALTH BENEFIT PLANS, EMPLOYEE; HUMANS; INSURANCE SELECTION BIAS; INSURANCE, PSYCHIATRIC; MANAGED CARE PROGRAMS; MEDICALLY UNINSURED; MENTAL HEALTH SERVICES; SOCIAL JUSTICE; UNITED STATES;

EID: 33744755042     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.25.3.623     Document Type: Review

References (41)

1. L. Reed, E. Myers, and P. Scheidemandel, Health Insurance and Psychiatric Care: Utilization and Cost (Washington: American Psychiatric Association, 1972).
2. T.G. McGuire, Financing Psychotherapy: Cost, Effects, and Public Policy (Cambridge: Ballinger Press, 1981).
3. There have also been equity arguments advanced against parity, based on the historical correlation of high income with use of outpatient psychotherapy. We do not discuss these arguments here, although we expect managed care to have had a "levelizing" effect over income groups.
4. R.G. Frank and T.G. McGuire, "Economics and Mental Health," in Handbook of Health Economics, ed. A.J. Culyer and J.P. Newhouse (North Holland: Elsevier, 2000), 893-954.
5. R.G. Frank and T.G. McGuire, "Economics and Mental Health" in Handbook of Health Economics, 2000, 893-954. Ibid.;
6. and J.P. Newhouse and the Insurance Experiment Group, Free for All? Lessons from the RAND Health Insurance Experiment (Cambridge, Mass.: Harvard University Press, 1993).
7. S. Glied, "Managed Care," in Handbook of Health Economics, ed. Culyer and Newhouse, 707-753.
8. C.A. Ma and T.G. McGuire, "Optimal Health Insurance and Provider Payment," American Economic Review 87, no. 4 (1997): 685-704;
9. and R.P. Ellis and T.G. McGuire, "Supply-Side and Demand-Side Cost Sharing in Health Care," Journal of Economic Perspectives 7, no. 4 (1993): 135-151.
10. G. Gately, "Wanted: Insurance Parity for Mental Illness," 15 May 2003, http://www.personalmd.com/hs/news/512667.html (accessed 17 March 2006).
11. A. King, Gubernatorial Veto Message to the Maine Legislature, 11 April 2002.
12. It is worth noting that the presence of nonprice rationing such as that found in managed care makes it difficult to "identify" the demand function empirically, there by making comparison of elasticities across eras more difficult. It also makes the comparison somewhat less relevant for policy.
13. Newhouse et al., Free for All?
14. B.S. Arons et al., "Mental Health and Substance Abuse Coverage under Health Reform," Health Affairs 13, no. 1 (1994): 192-205.
15. U.S. Bureau of Labor Statistics, National Compensation Survey: Employee Benefits in Medium and Large Size Firms, 1981, Bulletin no. 2140 (Washington: BLS, 1982).
16. BLS, National Compensation Survey: Employee Benefits in Medium and Large Size Firms, 1995, Bulletin no. 2496 (Washington: BLS, 1998).
17. S.M. Foote and S.B. Jones, "Consumer-Choice Markets: Lessons from FEHBP Mental Health Coverage," Health Affairs 18, no. 5 (1999): 125-130;
18. and D.K. Padgett et al., "The Effect of Insurance Benefit Changes on Use of Child and Adolescent Outpatient Mental Health Services," Medical Care 31, no. 2 (1993): 96-110.
19. R.G. Frank, "Regulatory Policy and Information Deficiencies in the Market for Mental Health Services," Journal of Health Politics, Policy and Law 14, no. 3 (1989): 477-501.
20. R.H. Miller and H.S. Luft, "HMO Plan Performance Update: An Analysis of the Literature, 1997-2001," Health Affairs 21, no. 4 (2002): 63-86.
21. M. Oss et al., Open Minds Yearbook of Managed Behavioral Health and Employee Assistance Program Market Share in the U.S., 2002-2003 (Gettysburg, Pa.: Open Minds, 2003).
22. Within the broader multistate literature on effects of state parity policies, none detected increased use of services, and one study that examined consumer spending found evidence of risk-protection benefits. This latter study was C.L. Barry and S.B. Busch, "Effects of State Parity Laws on Children with Mental Health Care Needs" (Working Paper, Yale School of Medicine, 2006).
23. U.S. Office of Personnel Management, "Call Letter for Contract Year 2001 - Policy Guidance," published as FEHB Program Carrier Letter no. 2000-17 (Washington: OPM, 2000).
24. C.B. Barry and M.S. Ridgely, "Health Plan Response to Regulation of Mental Health Coverage for Federal Employees" (Working Paper, Yale School of Medicine, 2006).
25. R.G. Frank, R.M. Conti, and H.H. Goldman, "Mental Health Policy and Psychotropic Drugs," Milbank Quarterly 83, no. 2 (2005): 271-298.
26. T.L. Mark et al., "U.S. Spending for Mental Health and Substance Abuse Treatment, 1991-2001," Health Affairs 24 (2005): w133-w142 (published online 29 March 2005; 10.1377/hlthaff.w5.133);
27. and R.M. Coffey et al., National Estimates of Expenditures for Mental Health and Substance Abuse Treatment (Rockville, Md.: U.S. Department of Health and Human Services, 2000).
28. U.S. Congressional Budget Office, CBO's Estimates of the Impact on Employers of the Mental Health Parity Amendment in H.R. 3101 (Washington: CBO, 13 May 1996);
29. J. Rodgers, "Analysis of the Mental Health Parity Provision of S. 1028" (Washington: Price Waterhouse, 1996);
30. M. Sing, "The Costs and Effects of Parity for Mental Health and Substance Abuse Insurance Benefits" (Washington: DHHS, 1998);
31. Watson Wyatt Worldwide, "The Costs of Uniform Plan Provisions for Medical and Mental Health Services: An Analysis of S. 298, the 'Equitable Health Care for Severe Mental Illness Act' " (Bethesda, Md.: Watson Wyatt Worldwide, 1996);
32. and R.E. Bachman, "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" (Atlanta: Coopers and Lybrand, 1996).
33. R.G. Frank et al., Estimating the Costs of Parity for Mental Health: Methods and Evidence (Princeton, N.J.: Robert Wood Johnson Foundation, 2001).
34. CBO, "Cost Estimate: S543 Mental Health Equitable Treatment Act of 2001" (Washington: CBO, 2001).
35. DHHS, Mental Health: A Report of the Surgeon General (Rockville, Md.: DHHS, 1999).
36. R.G. Frank, H.H. Goldman, and T.G. McGuire, "Will Parity in Coverage Result in Better Mental Health Care?" New England Journal of Medicine 345, no. 23 (2001): 1701-1704.
37. D. Mechanic and D.D. McAlpine, "Mission Unfulfilled: Potholes on the Road to Mental Health Parity," Health Affairs 18, no. 5 (1999): 11.
38. Z. Cao and T.G. McGuire, "Service-Level Selection by HMOs in Medicare," Journal of Health Economics 22, no. 6 (2003): 915-931.
39. D.A. Regier et al., "The de facto U.S. Mental and Addictive Disorders Service System: Epidemiologic Catchment Area Prospective One-Year Prevalence Rates of Disorders and Services," Archives of General Psychiatry 50, no. 2 (1993): 85-94;
40. R.C. Kessler et al., "Lifetime and Twelve-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results from the National Comorbidity Survey," Archives of General Psychiatry 51, no. 1 (1994): 8-19;
41. and P.S. Wang et al., "Twelve-Month Use of Mental Health Services in the United States: Results from the National Comorbidity Survey Replication," Archives of General Psychiatry 62, no. 6 (2005): 629-640.