Behavioral health benefits cut by half in last decade, analysis shows

Health-insurance companies are using managed care to cut behavioral health-care benefits substantially more than other health-care benefits, according to a new study by the Hay Group, an actuarial and benefits consulting firm in Washington, D.C.

Health Care Plan Design and Cost Trends: 1988 through 1997 is the first study to assess the impact of managed care on behavioral health care compared with other health care.

In the last decade, many health-insurance companies have cut the value of behavioral health-care benefits in half from $154.08 per covered individual in 1988 to $69.61 in 1997, the report says. In comparison, the value of other health-care benefits dropped only 7 percent, from $2,326.86 per covered individual in 1988 to $2,155.60 in 1997. In fact, behavioral health care as a percentage of total health-care benefits fell 50 percent from 6.2 percent in 1988 to 3.1 percent in 1997.

'The Hay Group study is simply one more piece of evidence that consumers are not able to access the care they need,' said C. Henry Engleka, assistant executive director of marketing for APA?s Practice Directorate. 'It points to the need for the directorate to redouble its ongoing efforts to help employers understand the risks to their employees? health care when businesses use managed care primarily as a cost-cutting strategy.'

In the last 10 years, the limits and caps insurance companies are placing on behavioral health-care benefits have become more stringent. For example, the number of plans that limit visits for outpatient behavioral health care has increased significantly since 1988, when only a quarter of all health plans restricted patients to 50 annual visits. Today, a plan that allows 50 visits is considered generous because nearly half of all health plans limit patients to 20 visits per year.

The study, prepared by the Hay Group?s Benefits Practice, is based on data from the Hay Benefits Report, which studies the health-care benefits provided by medium and large employers in the United States. All data were collected before the 1996 Mental Health Parity Act required equity between behavioral health-care benefits and other health-care benefits.

The report was commissioned by the National Association of Psychiatric Health Systems (NAPHS), the National Alliance for the Mentally Ill and the Association of Behavioral Group Practice. The NAPHS Education and Research Foundation funded the study.

?L. Rabasca