National trends in coverage and utilization of mental health, alcohol, and substance abuse services within managed health care systems.

Abstract

This study reports the results of a 1986 national survey of mental health, alcohol, and substance abuse services within health maintenance organizations in the United States. Ninety-seven percent ofresponding health maintenance organizations (HMOs) offered mental health service coverage and two-thirds of responding HMOs offered alcohol and substance abuse service coverage. Annual mean mental health hospitalization was 36.90 days per 1,000 members and annual mean ambulatory mental health utilization was 0.29 physician encounters per member. (Am J

A Voice From the Trenches: A Reaction to Ivey and Ivey (1998)

“…Second, substance abuse and mental disorders, both of which are listed in the DSM, are major public health problems in the United States (Levin, Glasser, & Haffee, 1988) affecting about 45 million people. Employers have been Counseling as a profession has experienced major expansions, from the traditional school setting into private practice, mental health agencies, and hospital settings (Dial et al, 1992;Gladding, 1992), necessitating that counselors report a DSM diagnosis for clients within the mental health system as well as with private insurers, managed care, or for clients participating in government programs.…”

Economic Costs, Cost-Effectiveness, Financing, and Community-Based Drug Treatment

“…Health maintenance organizations (HMOs) generally do not cover substance abuse treatment on a par with other treatment. Results from a 1986 national survey of mental health and substance abuse services within HMOs indicate that although two-thirds of the HMOs surveyed had alcohol and drug abuse benefits, 31 percent had only detoxification and emergency drug abuse coverage (Levin et al 1988). The median benefits for alcohol and other drug abuse coverage were 20 outpatient visits and 30 inpatient days.…”

Organizational and service delivery issues in managed mental health services.

“…Federal HMO legislation set the required mental health benefit package (for those seeking federal qualification) at 20 individual psychotherapy sessions per member per year. In practice, HMO MH/SA benefits usually include additional inpatient benefits, even though not all are federally qualified (Levin, Glasser, & Jaffee, 1988). Programs vary, however, in the requirement for and amount of copayment (Levin & Glasser, 19791, which may serve as a deterrent to utilization.…”