Managed mental health coverage affordable: study

By Gene Emery

BOSTON (Reuters) - Health insurance plans that offer mental health and substance abuse coverage may not be any more expensive than less comprehensive plans, a study shows.

The study, published in this week's New England Journal of Medicine, reviewed federal health care plans and found only one of the seven plans examined - the one that did not use managed care to try to control how often subscribers used the benefits - turned out to be more expensive than conventional plans.

Howard Goldman, a professor of psychiatry at the University of Maryland and the study's main author, said the findings suggest it is possible to offer mental illness and substance abuse as part of a package covering physical illnesses "without any adverse impact on cost and quality."

Insurance coverage of mental health services has been controversial. While psychological problems are a major cause of disability, getting insurers to pay for them is difficult because the problems can be difficult and expensive to treat.

In an editorial in the Journal, Columbia University scholars Sherry Glied and Alison Cuellar wrote: "Insurance for mental health care should enter the mainstream of coverage."

Unlike the federal plans studied, most private insurance and Medicare continue to have limits on mental health care.

The Goldman team found that health care costs increased when people were offered mental health coverage, but usually no more than for the people offered regular medical coverage.

In addition, subscribers to six of the seven plans had to pay less in out-of-pocket expenses.

A system where mental health and substance abuse care gets the same coverage as physical illness "is for everyone," Goldman said. "Implementing it with managed care means that this social good can be accomplished without adverse impact on access, cost or quality."