Study disputes claims about drug treatment costs
Study disputes claims about drug treatment costs
Adding an unlimited substance abuse care benefit to managed care plans would raise the cost by only $5.11 per member per year, a study has concluded.1
Putting a $10,000 limit on the annual substance abuse care benefits would reduce the cost by only 6 cents, down to $5.05 per member per year, concluded researchers at the RAND Corporation in Santa Monica, CA.
The study disputes insurance industry estimates that insurance payments would go up by as much as 9% if unlimited substance abuse payments were included. Concerns about cost have prompted state and federal legislators to exclude substance abuse treatment from laws mandating equal benefits for mental health and medical care.
"These concerns were based on actuarial simulations using treatment patterns from 10 or 20 years ago, not actual claims and services from a managed care company. In contrast, our study compared data from 25 managed care plans with unlimited substance abuse benefits for 1996 and 1997," says Roland Strum, PhD, the senior economist at RAND who led the study.
The study covered 25 plans managed by United Behavioral Health. The plans included comprehensive benefits, covering outpatient care, day treatment, residential, inpatient care, outpatient care, and recovery homes, and had no limits on substance abuse benefits. Copayments ranged from $0 to $10 per outpatient session.
The researchers compared the data with 200 employee-sponsored plans with annual dollar limits for substance abuse. The Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation funded the study.
Reference
1. Strum R. Weiying Z, Schoenbaum M. How expensive are unlimited substance abuse benefits under managed care?" Journal of Behavioral Health Services and Research 1999; 26:205-210.
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