Costs of mandates for outpatient mental health care in private health insurance

Benefit flexibility, cost shifting and mandated mental health coverage

This paper presents a policy analysis of options for making a state's mandated mental health benefit more flexible while maintaining insurance premiums at a constant level. The analysis illustrates the difficult choices facing legislatures that attempt to balance improved coverage for mental health care with concerns about rising health care costs. A sophisticated simulation model is used to assess the costs of four alternative insurance benefit design options.

Mental health monopoly: corporate trends in mental health services

Over the past 30 years, a number of important changes have occurred in the mental health system. This paper examines the origins and effects of these changes, utilizing a political-economic framework. Three main areas are emphasized: the increasing absorption of mental health care into the health care system in general; the ways in which care has been transferred away from traditional settings and responsibilities; and the movement of for-profit chains into mental health services. Particular focus is placed on the rationalizing and monopolizing tendencies increasingly evidenced in the mental health field.