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  1. How expensive is unlimited mental Health care coverage under managed care ?

    Article - En anglais

    Objectives

    - To study costs, access, and intensity of mental health care under managed care carve-out plans with generous coverage ; compare with assumptions used in policy debates ; and simulate the consequences of removing coverage limits for mental health care as required by the Mental Health Parity Act.

    Design

    - Claims data from 1995 and 1996 for 24 managed care carve-out plans ; all plans offered unlimited mental health coverage with minimal co-payments.

    Outcome Measures

    - Probability of care, intensity of care, and total costs broken down by service type and type of enrollee.

    Results

    - Assumptions used in last year's policy debate overstate actual managed care costs by a factor of 4 to 8. In the plans studied, costs are lower owing to reduced hospitalization rates, a relative shift to outpatient care, and reduced payments per service.

    However, access to mental health specialty care increased (7.0% of enrollees) compared with the preceding fee-for-service plans (6.5%) or free care in the RAND Health Insurance Experiment (5.0%). Removing an annual limit of $25 000 for mental health care, which is the average among plans currently imposing limits, will increase insurance payments only by about $1 per enrollee per year.

    Children are the main beneficiaries of expanded benefits.

    Conclusions

    - Concerns about costs have stifled many health system reform proposals. (...)

    Mots-clés Pascal : Santé mentale, Soin intégré, Economie santé, Analyse coût, Politique sanitaire, Homme, Etats Unis, Amérique du Nord, Amérique

    Mots-clés Pascal anglais : Mental health, Managed care, Health economy, Cost analysis, Health policy, Human, United States, North America, America

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0006914

    Code Inist : 002B30A01B. Création : 17/04/1998.