The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Impact on Quantitative Treatment Limits.

Détails

ID Serval
serval:BIB_3702110BB814
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Impact on Quantitative Treatment Limits.
Périodique
Psychiatric services
Auteur(s)
Thalmayer A.G., Friedman S.A., Azocar F., Harwood J.M., Ettner S.L.
ISSN
1557-9700 (Electronic)
ISSN-L
1075-2730
Statut éditorial
Publié
Date de publication
01/05/2017
Peer-reviewed
Oui
Volume
68
Numéro
5
Pages
435-442
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The Mental Health Parity and Addiction Equity Act (MHPAEA) significantly changed regulations governing behavioral health benefits for large, commercially insured employers. Pre-MHPAEA, many plans covered only a specific number of behavioral health treatment days or visits; post-MHPAEA, such quantitative treatment limits (QTLs) were allowed only if they were "at parity" with medical-surgical limits. This study assessed MHPAEA's effect on the prevalence of behavioral health QTLs.
Analyses used 2008-2013 specialty behavioral health benefit design data for Optum large-group plans, both carve-outs (N=2,257 plan-years, corresponding to 1,527 plans and 40 employers) and carve-ins (N=11,644 plan-years, 3,569 plans, and 340 employers). Descriptive statistics were calculated for limits existing at parity implementation, distinguished by accumulation period (annual or lifetime), level of care (inpatient, intermediate, or outpatient), unit (days, visits, or courses), condition, and network level. Proportions of plans using specific limits during the preparity (2008-2009), transition (2010), and postparity (2011-2013) periods were compared with Fisher's exact tests.
Preparity, the most common QTLs were annual visit or day limits. Accounting for overlap in limit types, 89% of regular carve-out plans, 90% of in-network-only carve-outs, and 77% of carve-in plans limited outpatient visits; 66% of regular carve-out plans, 74% of in-network-only carve-outs, and 73% of carve-ins limited inpatient or intermediate days. Postparity, QTLs almost entirely disappeared (p<.001).
Before MHPAEA, QTLs were common. Postimplementation, virtually all plans dropped such limits, suggesting that MHPAEA was effective at eliminating QTLs. However, increasing access to behavioral health care will mean going beyond such QTL changes and looking at other areas of benefit management.

Mots-clé
Health Benefit Plans, Employee/economics, Health Benefit Plans, Employee/legislation & jurisprudence, Health Benefit Plans, Employee/statistics & numerical data, Humans, Insurance Coverage/economics, Insurance Coverage/legislation & jurisprudence, Insurance Coverage/statistics & numerical data, Insurance, Health/economics, Insurance, Health/legislation & jurisprudence, Insurance, Health/statistics & numerical data, Mental Disorders/economics, Mental Disorders/therapy, Mental Health Services/economics, Mental Health Services/legislation & jurisprudence, Mental Health Services/statistics & numerical data, Substance-Related Disorders/economics, Substance-Related Disorders/therapy, United States, Behavioral health care policy, Insurance benefit design, Insurance benefit mandates, Insurance parity laws, Managed care, Mental illness & alcohol/drug abuse
Pubmed
Web of science
Open Access
Oui
Création de la notice
29/12/2016 15:16
Dernière modification de la notice
08/05/2019 17:03
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