Although the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Parity Act) increased access to mental health and substance use services in hospitals, according to new research from the Health Care Cost Institute, individuals continued to pay more out of pocket for substance use admissions than for other types of hospital admissions.

The Parity Act requires large group health plans to make behavioral health coverage rules similar to those that cover medical/surgical benefits. Large group plans were also required to make copays, deductibles, coinsurance, and out-of-pocket maximums for behavioral health care equivalent with the most common medical/surgical treatments.

The report, the first of its kind to look at hospital spending, utilization, prices, and out-of-pocket payments for mental health and substance use admissions, studied people who were 65 and under and had employer-sponsored health insurance. It found that spending on hospital admissions for mental health and substance use grew faster than spending on medical/surgical admissions between 2007 and 2011. Furthermore, patients with mental health conditions paid 10 percent of their hospital bill in 2011 and patients with substance use disorders paid 12 percent of their hospital bill. Medical or surgical patients paid just 4 percent of the total bill in comparison.
While federal and state mental health parity laws have seemingly made access to mental health services easier for individuals, a new study released in the April issue of Psychiatric Services, the journal of the American Psychiatric Association, says that many of those surveyed were not aware of their extended benefits.

Researchers studied the results of Timothy’s Law, New York’s state mental health parity law, by conducting telephone interviews with 54 employed individuals who had private insurance. Of the 54 respondents, 32 were adults diagnosed with mental illness and 22 were parents of children diagnosed with mental illness.

Most of those surveyed had been informed of their insurance coverage benefits before the state parity law went into effect in 2007, but were not aware of the extended coverage as a result of the law. Individuals also reported that their health plan provided unclear or incomplete information about their benefits, they had more difficulty obtaining information on mental health benefits than on medical/surgical benefits, and they felt their insurance companies were managing their mental health care benefits more aggressively than their medical/surgical benefits.

Those surveyed also reported difficulty finding a high-quality mental health care provider in their network as well as problems with health plan provider lists, such as outdated provider lists and long waits for appointments.

Forty-nine states have passed mental health parity legislation. What can be done in other states to educate individuals on their mental health benefits? What do you know about your state’s benefits?

To read more about this study, click here.