Behavioral Health Insurance Parity for Federal Employees.
Goldman, Howard H.; Frank, Richard G.; Burnam, M. Audrey; Huskamp, Haiden A.; Ridgely, M. Susan; Normand, Sharon-Lise T.; Young, Alexander S.; Barry, Colleen L.; Azzone, Vanessa; Busch, Alisa B.; Azrin, Susan T.; Moran, Garrett; Lichtenstein, Carolyn; Blasinsky, Margaret.
[Article]
New England Journal of Medicine.
354(13):1378-1386, March 30, 2006.
(Format: HTML, PDF)
Background: To improve insurance coverage of mental health and substance-abuse services, the Federal Employees Health Benefits (FEHB) Program offered mental health and substance-abuse benefits on a par with general medical benefits beginning in January 2001. The plans were encouraged to manage care.
Methods: We compared seven FEHB plans from 1999 through 2002 with a matched set of health plans that did not have benefits on a par with mental health and substance-abuse benefits (parity of mental health and substance-abuse benefits). Using a difference-in-differences analysis, we compared the claims patterns of matched pairs of FEHB and control plans by examining the rate of use, total spending, and out-of-pocket spending among users of mental health and substance-abuse services.
Results: The difference-in-differences analysis indicated that the observed increase in the rate of use of mental health and substance-abuse services after the implementation of the parity policy was due almost entirely to a general trend in increased use that was observed in comparison health plans as well as FEHB plans. The implementation of parity was associated with a statistically significant increase in use in one plan ( 0.78 percent, P<0.05) a significant decrease in use in one plan (-0.96 percent, P<0.05), and no significant difference in use in the other five plans (range, -0.38 percent to 0.23 percent; P>0.05 for each comparison). For beneficiaries who used mental health and substance-abuse services, spending attributable to the implementation of parity decreased significantly for three plans (range, -$201.99 to -$68.97; P<0.05 for each comparison) and did not change significantly for four plans (range, -$42.13 to $27.11; P>0.05 for each comparison). The implementation of parity was associated with significant reductions in out-of-pocket spending in five of seven plans.
Conclusions: When coupled with management of care, implementation of parity in insurance benefits for behavioral health care can improve insurance protection without increasing total costs.
N Engl J Med 2006;354: 1378-86.
Copyright (C) 2006 Massachusetts Medical Society. All rights reserved.
