Behavioral Health Coverage Under the Affordable Care Act: What Can We Learn From Marketplace Products?

Objective: The 2008 federal parity law and the 2010 Affordable Care Act (ACA) sought to expand access to behavioral health services. There was concern that health plans might discourage enrollment by individuals with behavioral health conditions who tend to be higher cost. This study compared behavi...

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Publicado en:Psychiatric Services Vol. 69; no. 3; pp. 315 - 322
Autores principales: Stewart, Maureen T., Horgan, Constance M., Hodgkin, Dominic, Creedon, Timothy B., Quinn, Amity, Garito, Lindsay, Reif, Sharon, Garnick, Deborah W.
Formato: Journal Article
Publicado: American Psychiatric Publishing, Inc. Mar2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: American Psychiatric Publishing, Inc.
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        atl: Behavioral Health Coverage Under the Affordable Care Act: What Can We Learn From Marketplace Products?
      aug:
        au:
          Stewart, Maureen T.
          Horgan, Constance M.
          Hodgkin, Dominic
          Creedon, Timothy B.
          Quinn, Amity
          Garito, Lindsay
          Reif, Sharon
          Garnick, Deborah W.
        affil: Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
      sug:
        subj:
          Patient Protection and Affordable Care Act Statistics and Numerical Data
          Health Insurance Exchanges Statistics and Numerical Data
          Insurance Coverage Statistics and Numerical Data
          Preferred Provider Organizations Statistics and Numerical Data
          Clinical Information Systems
          Mental Health Services Statistics and Numerical Data
          Health Maintenance Organizations Statistics and Numerical Data
          Surveys
          United States
      ab: Objective: The 2008 federal parity law and the 2010 Affordable Care Act (ACA) sought to expand access to behavioral health services. There was concern that health plans might discourage enrollment by individuals with behavioral health conditions who tend to be higher cost. This study compared behavioral health benefits available in the group insurance market (nonmarketplace) to those sold through the ACA marketplaces to check for evidence of less generous behavioral health coverage in marketplace plans.Methods: Data were from a 2014 nationally representative survey of commercial health plans regarding behavioral health services (80% response rate). The sample included the most common silver marketplace product and, as a comparison, the most common nonmarketplace product of the same type (for example, health maintenance organization or preferred provider organization) from each health plan (N=106 marketplace and nonmarketplace pairs, or 212 products).Results: Marketplace and nonmarketplace products were similar in terms of coverage, prior authorization, and continuing review requirements. Marketplace products were more likely to employ narrow and tiered behavioral health provider networks. Narrow and tiered networks were more common in state than in federal marketplaces.Conclusions: Provider network design is a tool that health plans may use to control cost and possibly discourage enrollment by high-cost users, including those with behavioral health conditions. The ACA was successful in ensuring robust behavioral health coverage in marketplace plans. As the marketplaces evolve or are replaced, these data provide an important baseline to which future systems can be compared.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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