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...
| Publicado en: | Psychiatric Services Vol. 69; no. 3; pp. 315 - 322 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
American Psychiatric Publishing, Inc.
Mar2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129760002&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129760002 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10752730 0Y1 jtl: Psychiatric Services issn: 10752730 maglogo: N pubinfo: dt: Mar2018 vid: 69 iid: 3 pid: 37323 pub: American Psychiatric Publishing, Inc. place: Arlington, Virginia artinfo: ui: 129760002 129760002 NLM29241429 10.1176/appi.ps.201700098 NLM29241429 129760002 ppf: 315 ppct: 7 formats: tig: 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 refInfo: holdings: @attributes: islocal: N |
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