Improving Mental Health Insurance Benefits Without Increasing Costs;Special rept

摘要

During any year, roughly a third of non-institutionalized civilians between ages 15 and 54 have a mental disorder. Yet workers who are covered by employer health plans typically find that their benefits for mental health (MH) services are much more limited than those for medical/surgical care. As a result, many in need of MH services may be forced for financial reasons to forgo them or discontinue treatment prematurely. Mental health problems take a heavy toll on the American economy, costing billions of dollars each year in lost productivity and increased absenteeism. This study suggests ways that MH benefits can be improved at little or no additional cost to employers. It is based on actuarial analysis, discussions with benefit design experts, and a review of the professional literature. This report describes benefit packages that incorporate some of these principles and have actuarial values equivalent or similar to benefits packages typically offered by employers. Because employee enrollment is highest in health maintenance organizations (HMOs) and PPOs, modification to MH packages offered by these two delivery systems will have the most far-reaching effects.