A survey of 434 managed care plans in 60 market areas found that patients receiving substance abuse and mental health services often had to make a higher copayment or pay a higher share of allowed charges than did patients receiving general medical care.

Researchers from Brandeis University found that at least 30 percent of the managed care service providers surveyed imposed higher cost sharing requirements for outpatient substance abuse and mental health treatment than for medical services. Among the plans using copayments (a fixed dollar amount per visit), the mean copayment for medical care was $11.73 compared to mean copayments of $17.39 for substance abuse treatment and $18 for mental health services. Similarly, among plans using co-insurance (a preset percentage of allowed charges), the mean co-insurance rate was significantly lower for medical care (19.1 percent) compared to 34.9 percent for substance abuse treatment and 35.9 percent for mental health services.

These findings imply that to achieve parity in behavioral health benefits, attention needs to be paid to cost sharing as well as to limits on benefits.

Dr. Dominic Hodgkin and colleagues from Brandeis University published this study in the March 2003 issue of the journal Medical Care Research and Review. The research was supported by grants from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the Substance Abuse and Mental Health Services Administration.

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Source: NIDA NewsScan