Implementation Of New Mexico's 'No Behavioral Health Cost Sharing' Law: A Qualitative Study.
Out-of-pocket spending is a long-standing challenge for privately insured people. New Mexico passed the first US law prohibiting private insurers from applying cost sharing to behavioral health treatment, effective January 1, 2022. We examined the perceptions of key informants, including clinicians,...
| Publicado en: | Health Affairs Vol. 43; no. 10; pp. 1448 - 1455 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Health Affairs Publishing, LLC
Oct2024
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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=190601351&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190601351 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Oct2024 vid: 43 iid: 10 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 190601351 190601351 190601351 10.1377/hlthaff.2024.00101 190601351 ppf: 1448 ppct: 7 formats: tig: atl: Implementation Of New Mexico's 'No Behavioral Health Cost Sharing' Law: A Qualitative Study. aug: au: Harris, Samantha J. Golberstein, Ezra Maclean, Johanna Catherine Stein, Bradley D. Ettner, Susan L. Saloner, Brendan affil: Johns Hopkins University, Baltimore, Maryland sug: subj: Behavioral Sciences Economics Health Care Costs Legislation and Jurisprudence Health Benefit Plans, Employee Legislation and Jurisprudence Program Implementation Funding Source New Mexico Human Qualitative Studies Semi-Structured Interview Snowball Sample Conceptual Framework Implementation Science Thematic Analysis Health Expenditures Health Policy Health Services Accessibility Insurance Coverage Workforce ab: Out-of-pocket spending is a long-standing challenge for privately insured people. New Mexico passed the first US law prohibiting private insurers from applying cost sharing to behavioral health treatment, effective January 1, 2022. We examined the perceptions of key informants, including clinicians, insurers, and state officials, about implementing the No Behavioral Health Cost Sharing law to explore how it might affect downstream outcomes such as spending and access. The law was viewed favorably and implemented without much difficulty. Clinicians noted widespread positive impacts, particularly for those needing intensive treatment. However, they worried about workforce capacity and the exclusion of people covered under self-insured employer plans, which are exempt from state regulation under the Employee Retirement Income Security Act (ERISA) of 1974. Insurers found the law to be in alignment with their organizational goals, but they expressed concern about the administrative burden caused by increased reviews of claims, and some were monitoring for unintended consequences (for example, waste and fraud) that could lead to increased premiums. Engagement strategies were needed to inform eligible members and facilitate enrollment in eligible plans. The law provides a potential model for states to improve access to behavioral health care, but impacts may be limited by factors such as workforce, awareness, and federal ERISA constraints. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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