Trends in employer-prov ided mental health and substance abuse benefits
Trends in employer-prov ided mental health and substance abuse benefits
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雇主提供的心理健康和药物滥用福利的趋势
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
Patricia Aleman
中科院分区：
文献类型：
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作者：
J. D. Morton;Patricia Aleman
雇主提供的心理健康保险在过去十年中经历了巨大的变化。在1996年《精神健康平等法案》（MHPA）通过之前，几乎所有雇主出资的健康保险计划都包括精神疾病，但福利传统上比其他疾病更严格例如，对精神疾病的保险通常期限较短，而且计划通常提供较低的年度和终身最高金额福利。这在门诊治疗中尤其如此。《卫生保健法案》对精神健康条款的主要影响是，要求精神健康福利的终身和年度美元限额的覆盖范围与医疗和外科福利的覆盖范围相同。来自劳工统计局国家薪酬调查（NCS）的数据显示，最近精神保健条款的变化影响了大多数参与者例如，对精神保健实行更严格的费用限制的医疗计划的雇员在住院治疗方面的比例从1997年的41%下降到2002年的7%，在门诊治疗方面从55%下降到7%相比之下，精神疾病住院天数少于其他疾病住院天数的医疗计划所涵盖的雇员比例从1997年的61%增加到2002年的77%。根据目前的估计，在一年的时间里，至少有五分之一的人被诊断出患有精神障碍。大约15%的精神障碍患者同时患有药物滥用障碍。4 .与精神健康福利类似，药物滥用福利通常受到比其他疾病福利更严格的单独限制。自1997年以来，雇主提供的药物滥用福利已出现变化，尽管这些变化并不总是像精神保健福利那样明显。1996年的MHPA没有影响药物滥用治疗的效益。例如，雇员参加有住院戒毒日限制的医疗保健计划的比例仅从1997年的53%增加到2002年的58%。相比之下，在同一时期，对住院戒毒病人施加费用限制的计划的发生率从37%下降到17%。本文介绍并比较了1997年雇员福利调查和2000年和2002年NCS5的数据，并提供了关于精神健康和药物滥用护理主题的简要背景、历史和经济观点。传统上，雇主为精神障碍和药物滥用治疗提供的保险比其他医疗保健福利更为严格；美国劳工统计局国家薪酬调查的最新数据显示，这些差异在缩小方面发生了实质性变化，这主要是由于州和联邦政府规定的福利。
Employer-provided mental health coverage has experienced dramatic changes over the last decade. Prior to the passage of the Mental Health Parity Act (MHPA) of 1996, nearly all employer-financed health insurance plans covered mental disorders, but benefits were traditionally more restrictive than for other illnesses.1 Coverage for mental disorders, for example, was usually for shorter periods, and plans generally provided lower annual and lifetime maximum dollar benefits. This was particularly true for outpatient care. The primary impact of the MHPA on mental health provisions was the requirement that coverage for lifetime and annual dollar limits for mental health benefits be the same as those for medical and surgical benefits. Data from the Bureau of Labor Statistics’ National Compensation Survey (NCS) show recent changes in mental healthcare provisions that affect most participants.2 For example, the incidence of employees in medical plans imposing more restrictive dollar limits on mental healthcare has decreased from 41 percent in 1997 to 7 percent in 2002 for inpatient care and from 55 percent to 7 percent for outpatient care.3 In contrast, the incidence of employees covered by medical plans that provide for fewer inpatient days of care for mental illness than for other medical conditions has increased from 61 percent in 1997 to 77 percent in 2002. According to current estimates, at least one in five people has a diagnosable mental disorder during the course of a year. Approximately 15 percent of those with mental disorders also suffer from a substance abuse disorder. 4 Similar to mental health benefits, substance abuse benefits have typically been subject to separate and more restrictive limits than benefits for other illnesses. Employer-provided substance abuse benefits have shown changes since 1997, although these changes have not always been as pronounced as those for mental healthcare benefits. The MHPA of 1996 did not affect substance abuse treatment benefits. The incidence of employees in medical care plans with day limits for inpatient detoxification, for example, has only increased from 53 percent in 1997 to 58 percent in 2002. In contrast, the incidence of plans imposing dollar limits for inpatient detoxification has dropped from 37 percent to 17 percent over the same period. This article presents and compares data from the Bureau’s 1997 Employee Benefits Survey and the 2000 and 2002 NCS5 and provides brief background, historical, and economic perspectives on the topics of mental health and substance abuse care. Traditionally, employer-provided coverage for mental disorders and substance abuse treatment has been more restrictive than for other medical care benefits; recent data from the BLS National Compensation Survey show substantive changes in narrowing some of those differences, primarily as a result of State and federally-mandated benefits.