The Politics And Economics Of Mental Health ‘Parity’ Laws

Frank, Richard G.; Koyanagi, Chris; McGuire, Thomas G.

doi:10.1377/hlthaff.16.4.108

Cited by 65 publications

(42 citation statements)

References 10 publications

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“…As Richard Frank and his colleagues have pointed out, the stringency of utilization management techniques applied to any given set of benefits, the incentives implicit in the financial contracts set up with providers, and the size and characteristics of the network of mental health providers all greatly influence enrollees' actual mental health benefits. 11 Only with information on how these aspects of benefits are changing can we fully assess the bottom-line implications for workers and their dependents.…”

Section: Discussionmentioning

confidence: 99%

Mental Health Insurance In The 1990s: Are Employers Offering Less To More?

et al. 1998

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Section: Discussionmentioning

confidence: 99%

Mental Health Insurance In The 1990s: Are Employers Offering Less To More?

et al. 1998

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“…18 This legislation requires employers to maintain the same annual and lifetime benefit limits for mental illness as they do for physical illness. Parity, however, is a somewhat hollow accomplishment because it does not prohibit employers from eliminating mental health coverage, differentially increasing coinsurance and deductibles, or setting limits on number of inpatient days and outpatient visits.…”

Section: The Parity Issuementioning

confidence: 99%

Emerging Trends In Mental Health Policy And Practice

Mechanic¹

1998

Health Affairs

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Managed care provides the potential for a more balanced system in the postinstitutional era of mental health care.by David Mechanic PROLOGUE: As managed care matures in the general health care market, and the problems of accountability and patients' rights continue to elude policymakers, it is not surprising that the mental health community casts a reluctant eye on managed care while at the same time submitting to it. This paper by David Mechanic examines the issues-such as deinstitutionalization, parity in benefits, and integration with general health care-that make the mental health arena a particularly challenging but very attractive environment for care management. Mechanic reminds us that managed care is first and foremost a business strategy and that its implementation in the mental health arena requires a social contract between purchasers, mental health professionals, advocates, and the government to ensure that patients receive appropriate care. Ultimately, says Mechanic, the effectiveness of managed behavioral health care will be determined not just by the accountability of managed care organizations but also by the willingness of all players in the system to commit to change and be responsible for it.

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“…12 The NAMHC (1997) predicted early that "partial or full parity generates strong incentives for plans to replace MENTAL 71 HEALTH the loss of demand side tools with new mechanisms on the supply side." This is not unique to mental health, as unmanaged health benefits have largely disappeared outside Medicare.…”

Section: Beyond Full Paritymentioning

confidence: 99%

Toward Full Mental Health Parity And Beyond

Gitterman

Scheffler

2001

Health Affairs

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The 1996 Mental Health Parity Act (MHPA), which became effective in January 1998, is scheduled to expire in September 2001. This paper examines what the MHPA accomplished and steps toward more comprehensive parity. We explain the strategic and self-reinforcing link of parity with managed behavioral health care and conclude that the current path will be difficult to reverse. The paper ends with a discussion of what might be behind the claims that full parity in mental health benefits is insufficient to achieve true equity and whether additional steps beyond full parity appear realistic or even desirable.T he 19 9 6 m ent al h ea lt h pa ri t y a ct (MHPA) was devised with a sunset provision to expire in September 2001. Although the rhetoric emphasized the removal of unfair barriers, the narrow scope of dollar limits (which permitted day and visit limits, as well as differential cost-sharing provisions) guaranteed that the actual effects were primarily symbolic rather than substantive. These were not unintended consequences. 1This paper examines what the MHPA accomplished and possible steps toward parity of mental health benefits with other medical coverage. We explain parity's strategic and self-reinforcing link with managed behavioral health care and conclude that the current path might be difficult to reverse. We end with a discussion of what might be behind the claims that full parity in benefits is insufficient to achieve true equity and whether additional steps beyond full parity appear realistic or even desirable. What Has The MHPA Accomplished?Although the 1996 MHPA has been criticized for what it did not do, it did place parity on the agenda and enabled state legislatures to experiment with more-comprehensive parity provisions. A majority of states mandate full parity: Plans are prohibited from any terms,

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The Politics And Economics Of Mental Health ‘Parity’ Laws

Cited by 65 publications

References 10 publications

Mental Health Insurance In The 1990s: Are Employers Offering Less To More?

Mental Health Insurance In The 1990s: Are Employers Offering Less To More?

Emerging Trends In Mental Health Policy And Practice

Toward Full Mental Health Parity And Beyond

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