TY - JOUR
T1 - Mental health benefit limits and cost sharing under managed care
T2 - A national survey of employers
AU - Salkever, David S.
AU - Shinogle, Judy
AU - Goldman, Howard
PY - 1999
Y1 - 1999
N2 - Mental health services experts suggest that managed care diminishes the need for arbitrary benefit limits and consumer cost-sharing. Data from 577 health plans were used to test the hypotheses that health maintenance organizations (HMOs) and carve-out plans are less likely to use benefit limits or service exclusions, have more generous limits, and have lower cost- sharing requirements than non-HMOs and non-carveout plans. The results show that HMOs were more likely to use service exclusions and did not make less use of benefit limits. Calve-outs were less likely to use some coverage exclusions. Comparisons of the stringency of limits and cost-sharing provisions did not show consistent differences.
AB - Mental health services experts suggest that managed care diminishes the need for arbitrary benefit limits and consumer cost-sharing. Data from 577 health plans were used to test the hypotheses that health maintenance organizations (HMOs) and carve-out plans are less likely to use benefit limits or service exclusions, have more generous limits, and have lower cost- sharing requirements than non-HMOs and non-carveout plans. The results show that HMOs were more likely to use service exclusions and did not make less use of benefit limits. Calve-outs were less likely to use some coverage exclusions. Comparisons of the stringency of limits and cost-sharing provisions did not show consistent differences.
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U2 - 10.1176/ps.50.12.1631
DO - 10.1176/ps.50.12.1631
M3 - Article
C2 - 10577886
AN - SCOPUS:0032717006
VL - 50
SP - 1631
EP - 1633
JO - Hospital and Community Psychiatry
JF - Hospital and Community Psychiatry
SN - 1075-2730
IS - 12
ER -