Behavioral Health Benefits In Employer-Sponsored Health Plans, 1997

Abstract

PROLOGUE: Concerns over disparities in the level of insurance coverage for mental health and substance abuse (MH/SA) treatment compared with general medical coverage were partly responsible for the Mental Health Parity Act of 1996, which took effect last year. In addition, fourteen states have passed legislation that goes beyond the requirements of the federal parity act. To track behavioral health care benefits in employer-sponsored insurance, researchers from the Substance Abuse and Mental Health Services Administration (SAMHSA) worked with employer survey experts from William Mercer to analyze questions on MH/SA benefits from the Mercer/Foster Higgins National Survey of Employer-Sponsored Health Plans. This paper represents the second publication of survey results in Health Affairs ; the first round appeared in July/August 1997. The authors found some improvement in benefits between 1996 and 1997. However, it is too early to tell if this improvement represents a permanent reversal in general terms. Jeffrey Buck, a clinical psychologist, is director of the Office of Managed Care in SAMHSA's Center for Mental Health Services (CMHS). Judith Teich is a policy analyst in the CMHS Office of Managed Care. Beth Umland is director of marketing and communications for William A. Mercer, Inc., and manages the annual Mercer/Foster Higgins health plans survey. Mitchell Stein is manager of employer surveys at Mercer. ABSTRACT: Data for 1997 show that three-quarters or more of employer-sponsored health plans continue to place greater restrictions on behavioral health coverage than on general medical coverage. The nature of these restrictions varies by plan type. Some improvement in the treatment of mental health/substance abuse (MH/SA) benefits in employer plans may be occurring, however. Comparisons with data from 1996 show that the proportion of plans with benefits for “alternative” types of MH/SA services, such as nonhospital residential care, has increased. Further, the proportion with special limitations on these benefits shows a modest decrease.

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