Literature DB >> 10565103

Benefit limits in managed behavioral health care: do they matter?

P B Peele1, J R Lave, Y Xu.   

Abstract

More than half of Americans with insurance coverage for mental health services are enrolled in plans that carve out behavioral health care services with a vendor specializing in the management of these services. However, utilization management has not taken the place of benefit limitations. Do benefit limits matter? This article reports the percentage of enrollees in managed behavioral health care carve-out plans that encounter benefit limits. Estimates are provided on the impact and savings of imposing benefit limits on enrollees in unrestricted plans. Costs to eliminate benefit limits are estimated to be very small. This study finds that benefit limits do matter but only to a very small number of plan enrollees. Furthermore, the results of this study show that for inpatient limits, children are especially vulnerable. These issues have important implications for discussions about the impact of managed care in mental health and for discussions concerning parity legislation.

Entities:  

Mesh:

Year:  1999        PMID: 10565103     DOI: 10.1007/bf02287303

Source DB:  PubMed          Journal:  J Behav Health Serv Res        ISSN: 1094-3412            Impact factor:   1.505


  7 in total

1.  Behavioral health benefits in employer-sponsored health plans, 1997.

Authors:  J A Buck; J L Teich; B Umland; M Stein
Journal:  Health Aff (Millwood)       Date:  1999 Mar-Apr       Impact factor: 6.301

2.  Mental health and marital stability.

Authors:  R G Frank; P Gertler
Journal:  Int J Law Psychiatry       Date:  1991

Review 3.  Mental health and substance abuse benefits in carve-out plans and the Mental Health Parity Act of 1996.

Authors:  R Sturm; J McCulloch
Journal:  J Health Care Finance       Date:  1998

4.  Costs and incentives in a behavioral health carve-out.

Authors:  C A Ma; T G McGuire
Journal:  Health Aff (Millwood)       Date:  1998 Mar-Apr       Impact factor: 6.301

5.  Savings from a Medicaid carve-out for mental health and substance abuse services in Massachusetts.

Authors:  R G Frank; T G McGuire
Journal:  Psychiatr Serv       Date:  1997-09       Impact factor: 3.084

6.  How expensive is unlimited mental health care coverage under managed care?

Authors:  R Sturm
Journal:  JAMA       Date:  1997-11-12       Impact factor: 56.272

7.  The social consequences of psychiatric disorders, III: probability of marital stability.

Authors:  R C Kessler; E E Walters; M S Forthofer
Journal:  Am J Psychiatry       Date:  1998-08       Impact factor: 18.112

  7 in total
  9 in total

Review 1.  Tracking changes in behavioral health services: how have carve-outs changed care?

Authors:  R Sturm
Journal:  J Behav Health Serv Res       Date:  1999-11       Impact factor: 1.505

2.  A test of mental health parity: comparisons of outcomes of hospital concurrent utilization review.

Authors:  Mary Ellen Murray; Jeffrey B Henriques
Journal:  J Behav Health Serv Res       Date:  2004 Jul-Sep       Impact factor: 1.505

3.  Impact of full mental health and substance abuse parity for children in the Federal Employees Health Benefits Program.

Authors:  Susan T Azrin; Haiden A Huskamp; Vanessa Azzone; Howard H Goldman; Richard G Frank; M Audrey Burnam; Sharon-Lise T Normand; M Susan Ridgely; Alexander S Young; Colleen L Barry; Alisa B Busch; Garrett Moran
Journal:  Pediatrics       Date:  2007-02       Impact factor: 7.124

4.  The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.

Authors:  Sarah Friedman; Haiyong Xu; Jessica M Harwood; Francisca Azocar; Brian Hurley; Susan L Ettner
Journal:  J Subst Abuse Treat       Date:  2017-06-26

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

Authors:  Amber Gayle Thalmayer; Sarah A Friedman; Francisca Azocar; Jessica M Harwood; Susan L Ettner
Journal:  Psychiatr Serv       Date:  2016-12-15       Impact factor: 3.084

6.  The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Nonquantitative Treatment Limits for Specialty Behavioral Health Care.

Authors:  Amber Gayle Thalmayer; Jessica M Harwood; Sarah Friedman; Francisca Azocar; L Amy Watson; Haiyong Xu; Susan L Ettner
Journal:  Health Serv Res       Date:  2018-05-08       Impact factor: 3.402

7.  Unmet need and problems accessing core health care services for children with autism spectrum disorder.

Authors:  Giuseppina Chiri; Marji Erickson Warfield
Journal:  Matern Child Health J       Date:  2012-07

8.  The impact of parity on major depression treatment quality in the Federal Employees' Health Benefits Program after parity implementation.

Authors:  Alisa B Busch; Haiden A Huskamp; Sharon-Lise T Normand; Alexander S Young; Howard Goldman; Richard G Frank
Journal:  Med Care       Date:  2006-06       Impact factor: 2.983

9.  Benefit limits for behavioral health care in private health plans.

Authors:  Dominic Hodgkin; Constance M Horgan; Deborah W Garnick; Elizabeth L Merrick
Journal:  Adm Policy Ment Health       Date:  2008-11-27
  9 in total

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