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APHA Scientific Session and Event Listing

Recorded presentation

M. Susan Ridgely, JD¹, M. Audrey Burnam, PhD¹, Colleen L. Barry, PhD², Howard H. Goldman, MD, PhD³, and Kevin D. Hennessy, PhD⁴. (1) The RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, (2) Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street #302, New Haven, CT 06520, (3) Department of Psychiatry, University of Maryland School of Medicine, 701 West Pratt Street, Baltimore, MD 21201, 310-983-1671, hh.goldman@verizon.net, (4) Office of Policy, Program and Budget, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Room 8-1017, Rockville, MD 20857

In collaboration with the Office of Personnel Management, we developed a Parity Reporting Requirement (PRR) to collect information about parity implementation from FEHB health plans. The PRR was composed of closed-ended, fixed choice items on changes in amount, scope or duration of MH/SA benefits; deductible, co-pay and co-insurance limits; use of MH/SA carve outs; use of risk-based contacting with vendors; composition of provider networks; financial relationships with providers; and use of utilization management controls. FEHB health plans expanded MH/SA benefits consistent with parity. While 7.7% of FEHB health plans (n=12) reported carving out MH/SA benefits in response to FEHB parity, these health plans represented about half of all FEHB enrollment. Among fee-for-service plans in the BCBS Service Benefit Plan, 25% of plans (n=41) reported carving out in response to parity, increasing the share of BCBS enrollees served by carve outs from 33% to 67% from pre to post-parity. Health plans reported increasing provider networks, but did not report changes in financial relationships with providers. There was little parity effect on the use of risk-based contracting. The effect of parity on the use of utilization management was mixed. For many of the FEHB health plans we studied, MH/SA benefits were delivered under managed care arrangements before the implementation of parity. Among those plans that did not previously manage MH/SA benefits, a number responded by carving out benefits to specialty vendors, but we did not find a strong parity effect for other supply-side techniques.

Learning Objectives:

• Define MH/SA parity in the FEHB Program
• Identify ways in which health plans modified policies and procedures in response to parity
• Analyze the potential effect of a full federal parity law on health plans in the U.S.

Keywords: Mental Health, Substance Abuse

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation