Experiences in California may provide valuable lessons for implementation of the federal parity legislation, such as the need to monitor not only plan costs and coverage but also access and quality. Results of research examining experiences in California over a five-year period appear in the December issue of Psychiatric Services, a journal of the American Psychiatric Association.

In 2000 California legislated parity coverage for mental health care-fully ten years before parity will take effect on a national level. Next year, federal legislation passed in 2008-the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act-will provide full parity for mental health and substance abuse coverage to 113 million people.

The study authors review the experiences of health plans, providers, and consumers in California between 2000 and 2005 in implementing mental health parity in the state, and discuss implications for implementation of the federal mental health parity law. Researchers collected data from a number of sources, including telephone interviews with state-level stakeholders, in-person interviews with community-based stakeholders, focus groups with providers, and focus groups with consumers.

According to the researchers, key lessons from the implementation experiences in California include:

- the need for increased oversight of health plans – monitoring health plan performance related to access and quality, in addition to monitoring coverage and costs;

- the need to look at the breadth of diagnoses covered by health plans; and

- the need to ensure consumer awareness of parity – mounting a campaign to education consumers about their insurance benefits.

“Health plans, providers, and consumer advocates all pointed to the challenge of educating consumers about the parity law, such as explaining what services are covered and to whom the law applies,” said the study’s lead author Margo L. Rosenbach, Ph.D. with Mathematica Policy Research. Nearly half of the participants in consumer focus groups were not familiar with the law even though most had a diagnosis covered by the law.

Co-authors on the report included Timothy K. Lake, Ph.D.; Susan R. Williams, M.P.P., also affiliated with the Mathematica Policy Institute, and Jeffrey A. Buck, Ph.D. with the Substance Abuse and Mental Health Services Administration.

Source
American Psychiatric Association