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Parity And The Use Of Out-Of-Network Mental Health Benefits In The FEHB Program

¹ Darrell Regier is executive director of the American Psychiatric Institute for Research and Education (APIRE) in Arlington, Virginia.
² Lynn Bufka is assistant executive director, Practice Research and Policy, at the American Psychological Association in Washington, D.C.
³ Tracy Whitaker is director of the Center for Workforce Studies, National Association of Social Workers (NASW), in Washington, D.C.
⁴ Farifteh Duffy is a research scientist at APIRE.
⁵ William Narrow is APIRE's associate director.
⁶ Donald Rae is director of research statistics and data management at APIRE.
⁷ Geoffrey Reed is senior consultant for WHO projects at the International Union of Psychological Science in Madrid, Spain.
⁸ Omar Rehman is project manager for practice research and policy at the American Psychological Association.
⁹ Maritza Rubio-Stipec is a senior scientist consultant at APIRE.
¹⁰ Toby Weismiller is the former director of professional development and advocacy at the NASW.
¹¹ Joshua Wilk is currently the supervisory clinical psychologist at the Walter Reed Army Institute of Research's Division of Psychiatry and Neuroscience in Silver Spring, Maryland.
¹² Joyce West is the director of APIRE's Practice Research Network.

^*Corresponding author.

Abstract

Two current congressional bills mandate parity for benefits for mental disorders with benefits for medical/surgical conditions in private insurance when mental health benefits are provided; the bills differ in regard to benefit levels and access to out-of-network coverage. This study assessed clinicians' and beneficiaries' participation in managed care networks in the national capital area under the Federal Employees Health Benefits (FEHB) parity program. Approximately one-third of the clinicians studied participated in FEHB networks, and only 44 percent of FEHB patients received care from network clinicians. Out-of-network mental health benefits are an important policy consideration to ensure access to mental health treatment under parity proposals. [Health Affairs 27, no. 1 (2008): w70-w83 (published online 18 December 2007; 10.1377/hlthaff.27.1.w70)]

Key Words: Access To Care, Business Of Health, Consumer Issues, Health Reform, Insurance Coverage, Mental Health/Substance Abuse, Health Spending, Politics

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