Psych Patients With Cost-Sharing Plans Use More Services

Study finds enrollees without parity insurance less likely to get timely outpatient care

TUESDAY, Dec. 23, 2008 (HealthDay News) -- People whose insurance plans better share the burden of the cost for mental health services use these programs more than those whose plans pick up less of the bill, a new study says.

The findings were based on a study of Medicare patients, some of whose plans provided equal cost-sharing and others whose plans put a greater cost burden on the patients. The patients in the study had recently received psychiatric discharges from facilities.

The study was published in the Dec. 24/31 issue of Journal of the American Medical Association.

U.S. health insurers have historically imposed higher out-of-pocket costs and greater restrictions for the use of mental health services than other medical illnesses.

"Advocates for parity [equal cost sharing] argue that restricted mental health coverage unfairly discriminates against individuals with mental illness. Because less than half of individuals with mental illness receive care for their condition, parity in insurance coverage could improve the use of effective treatment," the study authors, led by Amal N. Trived of the Warren Alpert Medical School at Brown University in Rhode Isalnd, wrote. "Timely outpatient mental health care following a psychiatric hospitalization is associated with fewer readmissions, more effective transitions to community-based services, and improved mental health outcomes."

The research team looked at outpatient mental and general medical services coverage for 302 Medicare health plans from 2001 to 2006. More than three-quarters of Medicare plans, which a wide majority of the enrollees had, called for patients to cover a greater portion of the cost for mental health care.

According to the study, enrollees whose plans split the costs were more likely to visit a mental health practitioner within a week or month after a hospitalization compared with enrollees in Medicare plans with intermediate or no cost parity.

Individuals with the lowest income or least education were among the least likely to have follow-ups in either the seven- or 30-day period, the researchers noted.

"Most Medicare health plans, like most commercial health plans, have unequal coverage for mental health services compared with other medical services. Enrollees in plans without parity in cost sharing are less likely to receive timely outpatient care following a hospitalization for mental illness," the authors concluded.

More information

The U.S. Social Security Administration has more about Medicare.

SOURCE: JAMA, news release, Dec. 23, 2008
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