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PubMed1992

If not now, when?

Explore the source record for details and available documents.

Cost-Benefit Analysis↗
PubMed2004

Behavioral health benefits: key to a healthy workforce.

Mental disorders exact a heavier toll on workplace productivity than do physical illnesses, but a complete behavioral health program is often looked upon as just one more driver of rate increases. Properly understood, promoted and utilized, however, behavioral health benefits can contribute to decreased absenteeism and increased productivity, and even help offset the treatment costs of medical disorders.

Efficiency↗
PubMed2004

Children with mental disorders: making sense of their needs and the systems that help them.

This paper examines the nature, severity, and prevalence of mental, behavioral, and emotional disorders among children, as well as the types of services that could help them. It looks at how they are served by the education, health care, and child welfare systems, and it identifies the gaps in these systems of care. It also examines the extent to which Medicaid, SCHIP, and private health insurance finance mental health care services for children.

Adolescent↗
PubMed2004

Mental health: what now?

Misguided policy decisions and cost crunching by payers have left many Americans with nowhere to turn for mental health services.

Health Policy↗
PubMed1992

[Current comments on Freud's treatment of "The question of lay analysis"].

The author gives a review on Freud's basic thoughts on lay analysis from 1926 and proceeds with the question why the Deutsche Psychoanalytische Vereinigung (German Psychoanalytic Association) admits only such candidates for psychoanalytic training who are physicians or psychologists. This corresponds with the policies of German health insurance agencies, which include only physicians directly or psychologists indirectly in their plans. He suggests that this attitude derives from a limited view of psychoanalysis, for which he names three different reasons: historical, institutional, and those that grow out of the specifics of psychoanalytic practice.

Freudian Theory↗
PubMed2000

Recent trends in the financing of substance abuse treatment: implications for the future.

OBJECTIVE: This article focuses on the implications of a recent study of substance abuse (SA) and mental health treatment expenditures for substance abuse treatment policy. Public and private expenditures for SA treatment are estimated and compared with those for mental health and all health care in the period between 1987 and 1997. METHODS/DATA SOURCES: Estimates of SA treatment expenditures were segregated from the Health Care Financing Administration's National Health Accounts across the ten-year period. Information about use, charges, and payments by provider type, payer, and diagnosis was obtained from numerous nationally representative data sets and large claims databases. Those data were used to estimate SA treatment expenditures in the general service sector. For the specialty sector two specialty facility surveys were used to estimate SA treatment expenditures. Information from the two sectors was combined and reconciled to the National Health Accounts. PRINCIPAL FINDINGS. A dramatic shift in SA expenditures away from private financing and toward public payers, as well as a shift away from hospital treatment settings, occurred between 1987 and 1997. CONCLUSIONS: Evidence from this article and other research suggests that growth in SA expenditures has been contained relative to growth in all health spending. How savings from SA treatment are being invested and whether expenditure levels are appropriate to supply treatment of acceptable quality needs further study.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1991

Employer-sponsored insurance coverage for alcohol and drug abuse treatment, 1988.

This paper uses 1988 Bureau of Labor Statistics data to analyze the content of insurance coverage for alcohol and drug abuse treatment offered by medium and large private sector firms. Ninety percent of workers had medical insurance. Of these, 81% had coverage for alcohol abuse treatment and 75.5% had coverage for drug abuse treatment. The coverages were almost always offered together, and the benefits were generally identical for both. Coverage for inpatient detoxification was most common, followed by outpatient care and inpatient rehabilitation. Self-insured plans, although exempt from state-mandated benefits, were as likely to include alcohol and drug abuse coverage as Blue Cross and Blue Shield and commercial plans, and their specific benefits were no less generous. Coverage limitations tended to be more restrictive for these illnesses than for others. The nature of the limitations varied greatly, although day and dollar limits were most common for inpatient treatment, and visit limits and higher copayments were most common for outpatient treatment.

Alcoholism↗
PubMedDate not supplied

Charges for substance abuse hospitalization: regional variations, 1990.

MetLife 1990 group health insurance costs for a substance abuse hospitalization averaged $7,660. The highest average total charges were reported in Texas and New Mexico, each with costs 30 percent or more above the U.S. average. The lowest average costs (those more than 30 percent below the norm) were reported in Oregon, Iowa, Minnesota and Massachusetts. Physician charges comprised less than 10 percent of the average total charges. Ancillary fees ranged from 6 percent of the hospital portion of the bill in Montana to 41 percent in Texas.

Ancillary Services, Hospital↗
PubMed1991

Employer health care plan design and its effect on plan costs.

This study uses claims data from employers in the Houston Area Health Care Coalition (HAHCC) for 1985 through the first half of 1987 to examine the effect of health care plan attributes on health care costs. Plan attributes affect the site of care and the costs of care. Utilization review clearly was effective in reducing the demand for inpatient services, but that reduction was in large measure matched by increases in care in the outpatient setting. Restrictions on mental health benefits also shifted the site of care. In contrast, neither premium sharing nor the plan's deductible had a significant impact on total plan charges. The study results demonstrate the need to have a comprehensive cost management strategy.

Adolescent↗
PubMed1990

Private health insurance of chronically ill children.

Accurate information regarding the adequacy of private health insurance coverage available to the families of chronically ill children is scarce. A national survey was conducted of firms offering health insurance to employees and their dependents. Data were collected concerning private health insurance coverage of services needed by chronically ill children, including basic medical care services, ancillary therapies, mental health services, and long-term care. Nearly all surveyed firms offered health insurance. Coverage of inpatient hospital care, outpatient physician services, medical supplies and equipment, x-ray studies, laboratory services, and prescription medications was widespread, but coverage of services such as physical therapy, speech therapy, occupational therapy, and nutrition services was much less prevalent. More than two thirds of the firms covered comprehensive home health services but often with limits and only in lieu of more expensive inpatient care. Long-term care, such as skilled nursing home care, was covered by only one third of firms. Overall, the survey results, combined with information concerning recent trends in private health insurance, reveal increasing coverage of lower cost alternatives to hospital or institutional care and improved maximum lifetime benefits and stop-loss coverage but also increased cost-sharing requirements. These results suggest that, although families with chronically ill children may have access to a widening range of services such as home health care or individual benefits management, they may be forced to bear an increasing proportion of the cost.

Child↗