Equity in private insurance coverage for substance abuse: A perspective on parity

Health Affairs

Volumn 26, Issue 6, 2007, Pages

  Barry, Colleen L ^a   Sindelar, Jody L ^a  

^a YALE UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADDICTION; ECONOMICS; ETHICS; HEALTH CARE DELIVERY; HEALTH INSURANCE; HUMAN; INSURANCE; LEGAL ASPECT; MENTAL HEALTH SERVICE; POLITICS; REVIEW; SOCIAL JUSTICE; SOCIOECONOMICS; UNITED STATES;

HEALTHCARE DISPARITIES; HUMANS; INSURANCE COVERAGE; INSURANCE, PSYCHIATRIC; MEDICAL INDIGENCY; MENTAL HEALTH SERVICES; POLITICS; SOCIAL JUSTICE; SUBSTANCE-RELATED DISORDERS; UNITED STATES;

EID: 36849069437     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.26.6.w706     Document Type: Review

References (51)

1. Bureau of Labor Statistics, National Compensation Survey: Employee Benefits in Private Industry in the United States, 2003, Bulletin no. 2577 (Washington, BLS, 2005).
2. U.S. Government Accountability Office, Mental Health Parity Act: Despite New Federal Standards, Mental Health Benefits Remain Limited, Pub. no. GAO/HEHS-00-05 (Washington: GAO, 2000).
3. D. Milbank, "Bush Backs Mental Health Parity," Washington Post, 30 April 2002.
4. The DSM-IV separates alcohol use disorders from psychoactive substance use disorders and distinguishes abuse from dependence.
5. S.S. Laudicina and K. Pardo, State Legislative Health Care and Insurance Issues: 1999 Survey of Plans (Washington: Blue Cross Blue Shield Association, 1999).
6. K.W. Hanson, "Public Opinion and the Mental Health Parity Debate: Lessons from the Survey Literature," Psychiatric Services 49, no. 8 (1998): 1059-1066.
7. R. Pear, "Proposals for Mental Health Parity Pit a Father's Pragmatism against a Son's Passion," New York Times, 19 March 2007.
8. "Mental Health Parity Bill Sails through Senate," Congress Daily, 19 September 2007.
9. SAMHSA, Results from the 2005 National Survey on Drug Use and Health: National Findings, NSDUH Series H-30, Pub. no. SMA-06-4194 (Rockville, Md.: SAMHSA, 2006).
10. R.M. Coffey et al., National Estimates of Expenditures for Substance Abuse Treatment, 1997, Pub. no. SMA-01-3511 (Rockville, Md.: SAMHSA, 2001).
11. 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);
12. and T.L. Mark et al., "Spending on Mental Health and Substance Abuse Treatment, 1987-1997," Health Affairs 19, no. 4 (2000): 108-120.
13. Self-help groups such as Alcoholics Anonymous and Narcotics Anonymous (not typically reimbursed under private insurance) and tobacco addiction services are not considered in this discussion.
14. Mark et al., "U.S. Spending."
15. SAMHSA, Results from the 2004 National Survey on Drug Use and Health: National Findings, NSDUH Series H-30, Pub. no. SMA-05-4062 (Rockville, Md.: SAMHSA, 2005).
16. BLS, National Compensation Survey (2003);
17. and J.R. Gabel et al., "Substance Abuse Benefits: Still Limited after All These Years," Health Affairs 26, no. 4 (2007): w474-w482 (published online 7 June 2007; 10.1377/hlthaff.26.4.474).
18. BLS, National Compensation Survey: Employee Benefits in Medium and Large Firms in the United States, 1982, Bulletin no. 2176 (Washington: BLS, 1983).
19. BLS, National Compensation Survey: Employee Benefits in Medium and Large Firms in the United States, 1988, Bulletin no. 2336 (Washington: BLS, 1989).
20. BLS, National Compensation Survey (2003).
21. Gabel et al., "Substance Abuse Benefits."
22. T.L. Mark and R.M. Coffey, "The Decline in Receipt of Substance Abuse Treatment by the Privately Insured, 1992-2001," Health Affairs 23, no. 6 (2004): 157-162.
23. B.F. Grant et al., "Prevalence and Co-occurrence of Substance Use Disorders and Independent Mood and Anxiety Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions," Archives of General Psychiatry 61, no. 8 (2004): 807-816.
24. See the online bibliography at http://content.healthaffairs.org/cgi/ content/full/hlthaff.26.6.w706/DC2.
25. C.J.Murray and A.D. Lopez, "Evidence-Based Health Policy - Lessons from the Global Burden of Disease Study," Science 274, no. 5288 (1996): 740-743.
26. See the online bibliography, as in Note 21.
27. Ibid.
28. T.L. Mark et al., National Estimates of Expenditures for Mental Health and Substance Abuse Treatment, 1991-2001, Pub. no. SMA-05-3999 (Rockville, Md.: SAMHSA, 2005).
29. L. Gowing, R. Ali, and J. White, "Buprenorphine for the Management of Opioid Withdrawal," Cochrane Database of Systematic Review no. 2 (2006): CD002025;
30. and B. Vastag, "In-Office Opiate Treatment: 'Not a Panacea': Physicians Slow to Embrace Therapeutic Options," Journal of the American Medical Association 290, no. 6 (2003): 731-735.
31. Vastag, "In-Office Opiate Treatment"; and R.G. Frank, H.A. Huskamp, and H.A. Pincus, "Aligning Incentives in the Treatment of Depression in Primary Care with Evidence-Based Practice," Psychiatric Services 54, no. 5 (2003): 682-687.
32. See online bibliography, as in Note 21.
33. Ibid.
34. U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General (Rockville, Md.: DHHS, 1999).
35. Vastag, "In-Office Opiate Treatment"; and Frank et al., "Aligning Incentives."
36. SAMHSA, Results from the 2005 National Survey on Drug Use and Health.
37. Ibid.
38. 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.
39. E.A. McGlynn et al., "The Quality of Health Care Delivered to Adults in the United States," New England Journal of Medicine 348, no. 26 (2003): 2635-2645.
40. R.G. Frank and T.G. McGuire, "Economics and Mental Health," in Handbook of Health Economics, vol. 1B, ed. A.J. Culyer and J.P. Newhouse (Amsterdam: North-Holland, 2000).
41. W.G. Manning et al., Effects of Mental Health Insurance: Evidence from the Health Insurance Experiment (Santa Monica, Calif.: RAND, 1989);
42. 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).
43. Mark and Coffey, "The Decline in Receipt of Substance Abuse Treatment."
44. R. Sturm, W. Zhang, and M. Schoenbaum, "How Expensive Are Unlimited Substance Abuse Benefits under Managed Care?" Journal of Behavioral Health Services and Research 26, no. 2 (1999): 203-210.
45. DHHS, Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report, 31 December 2004, http://aspe.hhs.gov/daltcp/ reports/parity.htm (accessed 18 September 2007).
46. Some of these increases were substantial. For example, in one plan, the probability of SA service use increased 0.16 percentage points, a 32 percent increase from pre- to post-parity.
47. M. Rosenbach et al., "Effects of the Vermont Mental Health and Substance Abuse Parity Law," Pub. no. SMA-03-3822 (Rockville, Md.: SAMHSA, 2003).
48. R.G. Frank, J. Glazer, and T.G. McGuire, "Measuring Adverse Selection in Managed Health Care," Journal of Health Economics 19, no. 6 (2000): 829-854.
49. In the era of managed care, benefit parity may be less able to address selection adverse concerns since health plans can control service use in alternative ways. For a discussion of this issue, see R.G. Frank and T.G. McGuire, "Parity for Mental Health and Substance Abuse Care under Managed Care," Journal of Mental Health Policy and Economics 1, no. 14 (1998): 153-159.
50. K.M. Harris and R. Sturm, "Adverse Selection and Generosity of Alcohol Treatment Benefits," Inquiry 39, no. 4 (2002/03): 413-428.
51. Sturmet al., "How Expensive Are Unlimited Substance Abuse Benefits?"