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At least 577 records · Page 32Linked to original sources
PubMed1990

Retrenchment or realignment? U.S. mental health policy and DRGs.

The introduction of DRGs for financing health care is dramatically changing the system of delivery and provision in the U.S. To understand the consequences, it is important to focus not only on cost-containment issues but also on new institutional mechanisms fashioned to reshape health care delivery and provision. A realignment among the major actors is occurring, with the state adopting a central role in redefining its own function in the health care system, constructing a new framework and agenda for change, and enlisting the participation of other social actors in implementing change. The specific features of this realignment are analyzed in the context of mental health DRGs. This article concludes that, based on the consequences of DRGs to date, we ought to look beyond present indicators of retrenchment in the health care system to how the unique features of the American welfare state are continuing to evolve.

Community Mental Health Centers↗
PubMed1990

Political and economic determinants of insurance regulation in mental health.

This article studies determinants of two important sets of laws regulating insurance coverage for mental health care: mandated inclusion of minimum coverage for psychotherapy, and mandated coverage for psychologist services, the so-called freedom of choice (FOC) laws. Political market models are developed and estimated to examine the passage of mandates and FOC laws among all fifty states from 1968 through 1983. Findings indicate that a number of groups influence whether these laws are passed, including psychologists and the state, which acts both in its own interests as a direct provider of services and to protect the public's interest. A state's political system and socioeconomic environment also influence the likelihood of passage of these regulations. Our findings run counter to the assumption often made by policymakers and researchers that regulations exclusively serve the interests of providers.

Community Mental Health Centers↗
PubMed1982

Mandated mental health benefits in private health insurance.

Eleven states mandate coverage of inpatient and outpatient mental health care in private health insurance. Health insurers have objected to these laws on the grounds that they interfere with consumer choice of health insurance benefits and are too costly. This paper analyzes the benefits and costs of mandates for psychotherapy. The potential benefits considered have to do with adverse selection in insurance markets and the offset effects of psychotherapy. Arguments based on economic efficiency are presented to justify the possible appropriateness of overriding individuals' choice of health insurance benefits. Mandates are estimated econometrically to increase the cost of psychotherapy in a state by about 10-20 percent. We conclude that mandates for mental health benefits in private health insurance may be reasonable state policy.

Actuarial Analysis↗
PubMed1993

Marketing guidelines for providers of mental health and chemical dependency services--responding to changes in the packaging and purchase of behavioral health benefits.

In summary, the mental health and chemical dependency market has changed to the point that providers and programs of any type can no longer survey financially without well-developed marketing strategies--including a conscious decision about target markets and niches within those markets. Behavioral health providers and programs need to thoroughly evaluate their internal resources, along with possible market niches, in order to develop these strategies.

Guidelines as Topic↗
PubMedDate not supplied

Children's access to mental health care: does insurance matter?

Using data from a 1992 community survey of children and their parents (or guardians), we found major gaps in mental health insurance coverage. Interestingly, private insurance had no statistically significant effect on use of mental health services. Youth without insurance coverage and those with public insurance had higher rates of serious emotional disorder than did those with private insurance. The analysis is based on the National Institute of Mental Health's Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, conducted in three mainland U.S. sites and in Puerto Rico.

Adolescent↗
PubMedDate not supplied

The politics and economics of mental health 'parity' laws.

The enactment of the Domenici-Wellstone amendment in September 1996, which calls for the elimination of certain limits on coverage for mental health care under private insurance, is being hailed as a major step forward in the quest for "parity" in mental health coverage. Parity legislation is being introduced in a number of state legislatures and is finding new enthusiasm in Congress. In this paper we consider the efficiency rationale for these laws and examine their likely impact in the era of managed care. We conclude that although such successes represent important political events, they may offer only small gains in the efficiency and fairness of insurance markets.

Health Services Accessibility↗