Mental Health Coverage in Health Care Reform
医疗改革中的心理健康覆盖
基本信息
- 批准号:8153773
- 负责人:
- 金额:$ 42.81万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2011
- 资助国家:美国
- 起止时间:2011-07-01 至 2013-06-30
- 项目状态:已结题
- 来源:
- 关键词:AddressCaringChronicChronic DiseaseCost SharingDataDimensionsEconomicsExpenditureFaceFamilyFederal GovernmentFranceGoalsHealth Care ReformHealth InsuranceHealth PlanningHealth StatusHealthcareImprove AccessIncentivesIncomeIndividualInsuranceLeftLegalLow incomeMainstreamingManaged CompetitionMarketingMassachusettsMeasuresMedicaidMedicalMental HealthMental disordersMethodologyMethodsModelingModificationOnline SystemsParticipantPatientsPatternPersonsPoliciesPopulationPovertyPricePsyche structureRegulationResearchRisk AdjustmentRunningSlideStructureSurveysTestingUninsuredUnited States National Institutes of HealthUpdateauthoritybasedesignevidence baseindexinginnovationmeetingsparityrisk selectionrisk sharingsound
项目摘要
DESCRIPTION (provided by applicant): An innovative and potentially far-reaching component of The Patient Protection and Affordable Care Act (ACA) is creation of new state-level health insurance markets referred to as "Exchanges." As of January 1, 2014, U.S. citizens and legal residents who are not eligible for employer-sponsored or public coverage will be able to purchase health insurance through new Exchanges, consolidating and regulating the market for individual insurance. Plans offered through the Exchanges will cover a federally defined "essential benefit package," which includes parity in coverage for mental health care. Premium and cost-sharing subsidies will apply on a sliding scale for individuals and families earning up to 400% of poverty. Extension of Exchange-based insurance to an estimated 24 million people promises to improve access to mental health care, provide financial protection, and integrate low-income groups into the mainstream of health care. A central lesson of economics and mental health in the past 30 years, however, is that competition and choice in private health insurance markets does not meet the needs of persons with mental illness (and other chronic conditions). The danger is: to avoid drawing an "adverse selection" of risks in a private health insurance market, Exchange plans may systematically under provide care for mental and other chronic illnesses. This project proposes to conduct fundamental economic research on the patterns of health care use by persons with mental illness in order to establish the evidence base for sound choices about structuring health insurance markets in the Exchanges. We plan to assess the magnitude of the selection problem among likely Exchange participants, and based on this, identify and evaluate options for correcting incentives to health plans to provide efficient and fair coverage for person with mental illness. In summary, we intend to: 1) Measure the strength of incentives for adverse selection among populations likely to participate in Exchanges using multiple years of nationally representative data from the Medical Expenditure Panel Survey (MEPS), and test whether selection-driven incentives are greater for mental health than other conditions. We will examine selection incentives at the individual and family level. 2) Evaluate the consequences for selection incentives of design choices in health insurance Exchanges, including: risk adjustment, risk-sharing, stop-losses, carve-outs, and limited choice of plans. Compare alternatives quantitatively within a unified theoretical and empirical framework. The goal is to guide policy so as to avoid pitfalls of the past in mental health and individual private health insurance markets. This proposal responds to Frances Collins' call to devote NIH research effort to benefit health care reform.
PUBLIC HEALTH RELEVANCE: As of January 1, 2014, US citizens and legal residents who are not eligible for employer- sponsored or public coverage will be able to purchase health insurance through new state-level health insurance markets, referred to as "Exchanges." This project proposes to conduct fundamental economic research on the patterns of health care use by persons with mental illness in order to establish the evidence base for sound choices about structuring health insurance markets in the Exchanges. We plan to assess the magnitude of the selection problem among likely Exchange participants, and based on this, identify and evaluate options for correcting incentives to health plans to provide efficient and fair coverage for person with mental illness.
描述(由申请人提供):《患者保护和平价医疗法案》(ACA)的一个创新和潜在影响深远的组成部分是建立新的国家级健康保险市场,即“交易所”。自2014年1月1日起,没有资格获得雇主资助或公共保险的美国公民和合法居民将能够通过新的交易所购买医疗保险,从而巩固和规范个人保险市场。医保交易所提供的计划将涵盖联邦政府规定的“基本福利计划”,其中包括精神卫生保健的平等保险。保费和费用分摊补贴将以浮动比例适用于收入高达贫困水平400%的个人和家庭。将基于交易所的保险扩大到大约2400万人,有望改善获得精神卫生保健的机会,提供财务保护,并将低收入群体纳入卫生保健的主流。然而,过去30年经济学和心理健康的一个中心教训是,私人健康保险市场的竞争和选择不能满足精神病(和其他慢性疾病)患者的需要。危险在于:为了避免在私人健康保险市场上造成风险的“逆向选择”,交换计划可能会系统地提供精神和其他慢性疾病的护理。该项目建议对精神疾病患者使用保健服务的模式进行基础经济研究,以便为在交易所建立健康保险市场的合理选择建立证据基础。我们计划在可能的交换参与者中评估选择问题的严重程度,并在此基础上,确定和评估纠正健康计划激励的选择,以为精神疾病患者提供有效和公平的覆盖。总之,我们打算:1)使用来自医疗支出小组调查(MEPS)的多年全国代表性数据来衡量可能参与交换的人群中逆向选择激励的强度,并测试选择驱动的激励是否对心理健康比其他状况更大。我们将研究个人和家庭层面的选择动机。2)评估健康保险交易中设计选择对选择激励的影响,包括:风险调整、风险分担、止损、分拆和有限的计划选择。在统一的理论和经验框架内定量比较备选方案。目标是指导政策,以避免过去精神健康和个人私人健康保险市场的陷阱。该提案回应了弗朗西斯·柯林斯(Frances Collins)的呼吁,即将NIH的研究努力用于医疗改革。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Thomas G. McGuire其他文献
Organizational structure and state mental health expenditures
- DOI:
10.1007/bf02108685 - 发表时间:
1996-07-01 - 期刊:
- 影响因子:2.700
- 作者:
Karen Jacobsen;Thomas G. McGuire;Elizabeth Notman - 通讯作者:
Elizabeth Notman
Special issue: Introductory remarks
- DOI:
10.1007/bf00706487 - 发表时间:
1990-09-01 - 期刊:
- 影响因子:2.700
- 作者:
Thomas G. McGuire - 通讯作者:
Thomas G. McGuire
The Comparative Advantage of Medicare Advantage
医疗保险优势的比较优势
- DOI:
- 发表时间:
2018 - 期刊:
- 影响因子:3.7
- 作者:
Joseph P. Newhouse;M. Landrum;M. Price;Michael McWilliams;J. Hsu;Thomas G. McGuire - 通讯作者:
Thomas G. McGuire
Adoption of a Cost-Saving Innovation: Germany, UK and Simvastatin
采用节省成本的创新:德国、英国和辛伐他汀
- DOI:
- 发表时间:
2011 - 期刊:
- 影响因子:0
- 作者:
Thomas G. McGuire;Sebastian Bauhoff;Norbert Klusen;Frank Verheyen;Caroline S. Wagner - 通讯作者:
Caroline S. Wagner
Mental Health Treatment and Criminal Justice Outcomes
心理健康治疗和刑事司法结果
- DOI:
- 发表时间:
2010 - 期刊:
- 影响因子:0
- 作者:
Richard G. Frank;Thomas G. McGuire - 通讯作者:
Thomas G. McGuire
Thomas G. McGuire的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Thomas G. McGuire', 18)}}的其他基金
Mental Health Coverage and Payment in Private Health Plans
私人健康计划中的心理健康承保和付款
- 批准号:
8694370 - 财政年份:2011
- 资助金额:
$ 42.81万 - 项目类别:
Learning from Program Differences between Medicaid and Medicare
从医疗补助和医疗保险之间的计划差异中学习
- 批准号:
10379884 - 财政年份:2009
- 资助金额:
$ 42.81万 - 项目类别:
Learning from Program Differences between Medicaid and Medicare
从医疗补助和医疗保险之间的计划差异中学习
- 批准号:
10196905 - 财政年份:2009
- 资助金额:
$ 42.81万 - 项目类别:
Learning from Program Differences between Medicaid and Medicare
从医疗补助和医疗保险之间的计划差异中学习
- 批准号:
10616717 - 财政年份:2009
- 资助金额:
$ 42.81万 - 项目类别:
Economics of Racial & Ethnic Disparities in MH Services
种族经济学
- 批准号:
6670050 - 财政年份:2004
- 资助金额:
$ 42.81万 - 项目类别:
Economics of Racial & Ethnic Disparities in MH Services
种族经济学
- 批准号:
6853487 - 财政年份:2004
- 资助金额:
$ 42.81万 - 项目类别:
相似海外基金
A self-guided and monitored innovative AI-driven parental support intervention (mobile app), for families caring for a young one that self-harms: feasibility study
一种自我指导和监控的创新型人工智能驱动的家长支持干预措施(移动应用程序),适用于照顾自残儿童的家庭:可行性研究
- 批准号:
10101171 - 财政年份:2024
- 资助金额:
$ 42.81万 - 项目类别:
Collaborative R&D
Caring Communities 1800-present: Rethinking Children's Social Care
关爱社区 1800 年至今:重新思考儿童的社会关怀
- 批准号:
MR/X034968/1 - 财政年份:2024
- 资助金额:
$ 42.81万 - 项目类别:
Fellowship
Conference: Caring for the Future: Empathy in Engineering Education
会议:关爱未来:工程教育中的同理心
- 批准号:
2418876 - 财政年份:2024
- 资助金额:
$ 42.81万 - 项目类别:
Standard Grant
Who is Caring for the Caregiver? Understanding Quality of Life and Mental Health Outcomes in Caregivers of Persons with Brain Injury
谁在照顾看护者?
- 批准号:
492369 - 财政年份:2023
- 资助金额:
$ 42.81万 - 项目类别:
Operating Grants
When caring ends: Understanding and supporting informal care trajectories
当护理结束时:理解和支持非正式护理轨迹
- 批准号:
LP220100209 - 财政年份:2023
- 资助金额:
$ 42.81万 - 项目类别:
Linkage Projects
Caring for Providers to Improve Patient Experience (CPIPE) Study
关爱医疗服务提供者以改善患者体验 (CPIPE) 研究
- 批准号:
10556284 - 财政年份:2023
- 资助金额:
$ 42.81万 - 项目类别:
Intergenerational conversations in contemporary performance: conflict, caring and the earth crisis
当代表演中的代际对话:冲突、关怀和地球危机
- 批准号:
2887471 - 财政年份:2023
- 资助金额:
$ 42.81万 - 项目类别:
Studentship
Evaluation of the Caring Letters Suicide Prevention Intervention after Removal of an Electronic Health Record Flag for Suicide Risk: An Effectiveness-Implementation Hybrid Type 2 Trial
移除电子健康记录自杀风险标记后关怀信自杀预防干预的评估:有效性-实施混合 2 型试验
- 批准号:
10753299 - 财政年份:2023
- 资助金额:
$ 42.81万 - 项目类别:
Co-creating a new model of long-term care home for older adults experiencing homelessness: Long-term Caring
为无家可归的老年人共同打造长期护理院新模式:长期关怀
- 批准号:
490004 - 财政年份:2023
- 资助金额:
$ 42.81万 - 项目类别:
Operating Grants
Intergenerational conversations in contemporary performance: conflict, caring and the earth crisis.
当代表演中的代际对话:冲突、关怀和地球危机。
- 批准号:
2904652 - 财政年份:2023
- 资助金额:
$ 42.81万 - 项目类别:
Studentship