Provision of Drug Abuse Treatment Services Under Parity

描述(由申请人提供)：医疗保健系统的变化使我们有必要定期更新我们关于如何提供药物使用障碍服务的知识。在目前的环境下，这一点尤其重要，因为最近通过了联邦平价立法，要求提供精神健康/成瘾服务的团体健康计划以与医疗/外科服务类似的方式涵盖这些服务，对大多数健康计划来说，从2010年1月1日起生效。在我们前两轮健康计划调查的基础上，我们建议(1)通过增加关于药物滥用治疗的具体问题和关于平等的深入单元，加强计划于2010年进行的“核心”第三轮调查，以及(2)在2012年进行一次后续调查，重点是在发布最终的平等规则和完成2011年费用选择退出规定后的健康计划反应。具体目标是： *从行政和临床因素方面描述在私人保健计划中为药物使用障碍提供服务的情况，加强2010年福利年度的调查，特别侧重于药物滥用服务，并通过与1999年和2003年的前两轮调查相比较，分析过去十年健康计划提供这些服务的变化。 *研究卫生计划对2010年1月1日实施联邦平价立法的具体反应，深入分析因平价而特别通过的变化，方法是通过一个关于平价的特殊模块加强2010年的调查。 *研究卫生计划对2012年福利年联邦平价立法的进一步反应，此前要求所有在2011年选择退出的计划都要在2012年参加，并发布了预计将于2011年生效的澄清最终条例。 *2010年至2012年医疗保险计划实施平价的范本变化，反映了对平价规定和费用选择退出规定的反应变化。 拟议的药物治疗服务研究将结合1999、2003和2010年的轮次以及2012年我们具有全国代表性的健康计划调查的平价后续行动，进行前瞻性设计，使我们能够跟踪药物服务的提供如何在不断变化的医疗保健市场中发展。它将特别关注与联邦平等有关的问题，特别是根据法规和费用选择退出条款对医疗计划的反应。 公共卫生相关性：医疗保健系统的变化，如联邦立法带来的平等待遇，使得我们有必要定期更新我们对如何提供药物滥用服务的知识。健康计划的决定不仅可以影响是否认识到问题，还可以影响患者获得护理的机会，以及他们接受的护理的质量和成本。我们2010年健康计划调查和2012年平价跟踪调查的增强将提供私人医疗计划中复杂和不断变化的药物滥用治疗服务组织的当前图景，该计划覆盖了美国65岁以下的大多数人。

DESCRIPTION (provided by applicant): Changes in the health care system make it necessary to regularly update our knowledge of how services for drug use disorders are provided. It is particularly important in the current environment because of the recent passage of federal parity legislation which requires group health plans offering mental health/addiction services to cover these services in a comparable manner to medical/ surgical services, effective January 1, 2010 for most health plans. Building on two previous rounds of our health plan survey, we propose to (1) enhance the "core" third round planned for 2010 by adding specific questions on drug abuse treatment and an in-depth module on parity, and (2) conduct a follow-up survey in 2012 focused on health plan response after final parity regulations have been issued and the 2011 cost opt-out provision is finished. The specific aims are: * Describe the provision of services for drug use disorders in private health plans in terms of administrative and clinical factors by enhancing a survey for benefit year 2010 to specifically focus on drug abuse services and analyze changes in health plans' provision of these services in the last decade by comparing to previous rounds of the survey in 1999 and 2003. * Study health plans' specific responses to the implementation of federal parity legislation on January 1, 2010 with an in-depth analysis of changes that were specifically adopted because of parity, by enhancing the 2010 survey through a special module on parity. * Study health plans' further responses to federal parity legislation in benefit year 2012, following both the requirement that all plans opting out in 2011 participate in 2012 and the issuance of clarifying final regulations expected to go into effect in 2011. * Model changes from benefit year 2010 to 2012 in health plans' implementation of parity, reflecting changes in response to parity regulations and the cost opt-out provision. The proposed study of drug treatment services will combine the 1999, 2003, and the 2010 rounds and the 2012 parity follow-up of our nationally representative health plan survey in a prospective design that will allow us to track how the delivery of drug services evolves within the changing health care market. It will specifically focus on issues related to federal parity, particularly health plan response in light of regulations and cost opt- out provisions. PUBLIC HEALTH RELEVANCE: Changes in the health care system, such as parity due to federal legislation, make it necessary to regularly update our knowledge of how drug abuse services are provided. Health plan decisions can influence not only whether there is recognition of a problem, but also patients' access to care, and the quality and cost of care they receive. The enhancement of our 2010 health plan survey and the 2012 parity follow-up survey will provide a current picture of the complex and changing organization of drug abuse treatment services in private health plans, which cover the majority of people under 65 in the U.S.