Program/Policy Selected: The Medicare Improvements for Mental Health (MH) Parity Act of 2008
Evaluation Source: “Evaluation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)” by the Government Accountability Office (GAO) (https://www.gao.gov/products/gao-22-105912)
Program Description: The MH Parity Act aims to eliminate the financial disincentives for people with mental health or substance use disorders (MH/SUD) to seek treatment by ensuring that health insurance plans offer coverage for mental health services that is comparable in financial terms (e.g., co-pays, deductibles) to coverage for medical/surgical services.
Program Outcomes:
- Increased access to MH/SUD treatment: Studies have shown an increase in MH/SUD service utilization among commercially insured individuals following the implementation of MH Parity.
- Reduced financial burden: The program helped to lessen the financial burden of mental health treatment for patients.
- Potential for workforce shortages: Concerns arose regarding a potential shortage of qualified mental health professionals to meet the increased demand for services.
Measuring Program Success:
The GAO evaluation used several measures to assess the effectiveness of MH Parity:
- Changes in MH/SUD service utilization rates based on insurance claims data.
- Employer surveys to understand their experiences with the program.
- Interviews with stakeholders including mental health providers, insurers, and consumer advocates.
- Analysis of state enforcement activities regarding MH Parity compliance.
People Reached:
The MH Parity Act applies to group health plans offered by private employers and health insurance issuers covering millions of Americans. However, the exact number of individuals who directly benefited from increased access to MH/SUD treatment is difficult to quantify.
Impact Realized:
The program has had a positive impact on increasing access to mental health treatment and reducing the financial barrier for patients. However, concerns remain regarding workforce shortages and the need for continued enforcement to ensure compliance.
Evaluation Timing:
The GAO evaluation was conducted several years after the program’s implementation, allowing for a longer-term analysis of its effects.
Evaluation Data:
The evaluation used a mixed-methods approach with both quantitative (claims data) and qualitative data (interviews, surveys) to provide a comprehensive picture of the program’s effectiveness.
Unintended Consequences:
One identified unintended consequence was the potential for increased wait times for MH/SUD services due to the rise in demand for treatment. Additionally, some concerns arose regarding potential cost-shifting by insurers to offset the increased coverage for mental health services.
Stakeholders:
The key stakeholders involved in the MH Parity program include:
- Patients with MH/SUD: They benefit from increased access to affordable mental health treatment.
- Mental health providers: They experience higher demand for their services, but may also face challenges with capacity and reimbursement rates.
- Employers: They are responsible for offering compliant health insurance plans but may face increased costs.
- Health insurers: They must adjust their coverage plans to comply with the parity requirements.
- Policymakers: They have an interest in ensuring the program’s effectiveness and addressing any unintended consequences.
Meeting Original Objectives:
The MH Parity Act has achieved some of its original objectives by increasing access to mental health treatment and reducing financial barriers for patients. However, challenges remain regarding workforce shortages and enforcing compliance.
Program Recommendation:
The MH Parity Act is a valuable program that has expanded access to mental health services. Continued monitoring and adjustments may be needed to address workforce shortages and ensure long-term effectiveness. Implementing similar policies in workplaces could be beneficial, particularly for organizations that self-insure or offer employee health insurance plans. This can promote employee well-being and potentially reduce healthcare costs associated with untreated mental health conditions. However, careful consideration should be given to potential challenges like provider capacity and cost implications before implementation.
