(Press-News.org) PROVIDENCE, R.I. [Brown University] — Despite the intent of recent mental health "parity" legislation, including the Affordable Care Act, even steep reductions in co-pays for outpatient mental health care will not motivate more seniors in managed care plans to seek that care, according to a new study by Brown University researchers.
Parity measures, included in laws passed in 2008 and 2010, end an insurance industry practice of charging higher co-pays for mental health care than for other care. While the laws will allow many seniors who undergo treatment to save money, said Amal Trivedi, professor of community health at Brown University, the new findings suggest that co-pays are not the main barrier to care.
In the study published online Feb. 4 in the journal Medical Care, Trivedi and graduate student Chima Ndumele found that seniors did not start mental health care when co-pays dropped and did not quit when they rose.
"Less than half of people with a mental health condition actually seek mental health services," said Trivedi. "The hope was that insurance parity and reducing co-pays would increase the number of people who would do so. We found that's unlikely to be the case. At least for this population in managed care plans, rather large increases or decreases in co-pays have no effect on the likelihood of receiving any outpatient mental health care."
A measurable non-effect
To perform their analysis, Trivedi and Ndumele combed through 252 Medicare plans with outpatient mental health services. They ultimately found 14 that raised co-pay rates by more than 25 percent in the last year of a three-year period, and that could be compared to plans that were similar except that they held co-pay rates constant. They also found three plans that lowered rates by more than 25 percent in a third year that could also be compared to comparable control plans that did not change their co-pay.
Among enrollees in the 14 plans that raised rates, an average of 2.2 percent used mental health services both before and after the increase. In the case of the plans that lowered rates, participation in mental health care held steady at 1.2 percent of enrollees, despite the discount. In both cases, the plans that did not change co-pays averaged a 0.1-percent drop in mental health service use. In short, mental health service use essentially remained unchanged no matter what happened to the co-pay.
The non-effect held true for almost every demographic breakdown of the enrollees, except that black seniors seemed to be motivated by reduced co-pays, increasing their participation in mental health care by almost a whole percentage point.
Barriers remain
Trivedi said at least a partial explanation for the tiny effect of co-pay changes is that other common insurance company policies may have a stronger effect on limiting use of mental health services for most seniors. Those policies include requiring prior authorization of care from primary care doctors and the insurer, and restricted networks of doctors approved to provide mental health care.
"The people who actually receive mental health services have already overcome these additional barriers to use of services," he said. "If the plan had prior authorization or restricted network, it meant enough for them to go past those barriers. Putting in another co-pay increase didn't dissuade them from receiving services."
Similarly, Trivedi said, these policies are probably more of a barrier to seniors starting care than the level of the co-pay.
"Enacting parity is just one step in creating an environment in which individuals in need of mental health services will seek care," added Ndumele. "Our study indicates that we must identify other steps beyond insurance parity to promote the appropriate use of mental health services among the elderly."
###
The study was funded by the National Institutes of Health through a grant from the Minority Opportunities for Research (MORE) Division of the National Institute of General Medical Sciences.
Lower mental health co-pays do not help seniors seek care
2011-02-09
ELSE PRESS RELEASES FROM THIS DATE:
The great tonsil dilemma
2011-02-09
ANN ARBOR, Mich. — Without fanfare, hundreds of thousands of children surrender their tonsils to a surgeon's scalpel each year, usually to alleviate recurring infections and obstructive sleep problems. Most of the time, the snipped tonsils are sent to a pathologist, who looks for evidence of more serious medical problems, like unsuspected cancer.
But this common practice may not be cost-effective because those additional examinations rarely lead to the discovery of hidden disease, a new University of Michigan Heath System analysis shows.
The approximately $35 million ...
CeBIT 2011: Electronic fitness trainer
2011-02-09
This release is available in German.
Eating a healthier diet, getting more exercise and doing more sports – lots of people recommit themselves to these goals over and over. But one's baser instincts are often stronger and invincible. On the couch in the evening, you take stock of the day only to admit that you have failed to rally once again. And yet, physical fitness is now considered a remedy for many illnesses. Particularly for older people, daily exercise is important – not only during rehabilitation following major surgery but also for one's general sense of physical ...
The success of male bustards is measured by their 'beards'
2011-02-09
Up until now it was unknown whether males of the great bustard (Otis tarda), an emblematic bird in Spain and endangered at a global level, transmit information on their weight, size, and age through their plumage. For the first time a study shows that the 'beards' and the design of the neck are "reliable" indicators of the weight and age of their bearers, and are used to both avoid fights with competitors and to attract females.
"The heaviest males (best physical condition) make it known to other males through the length and number of 'beards', and thereby avoid bloody ...
Fingerprint makes chips counterfeit-proof
2011-02-09
This release is available in German.
Product piracy long ago ceased to be limited exclusively to the consumer goods sector. Industry, too, is increasingly having to combat this problem. Cheap fakes cost business dear: The German mechanical and plant engineering sector alone lost 6.4 billion euros of revenue in 2010, according to a survey by the German Engineering Federation (VDMA). Sales losses aside, low-quality counterfeits can also damage a company's brand image. Worse, they can even put people's lives at risk if they are used in areas where safety is paramount, ...
The most genes in an animal? Tiny crustacean holds the record
2011-02-09
Scientists have discovered that the animal with the most genes--about 31,000--is the near-microscopic freshwater crustacean Daphnia pulex, or water flea.
By comparison, humans have about 23,000 genes. Daphnia is the first crustacean to have its genome sequenced.
The water flea's genome is described in a Science paper published this week by members of the Daphnia Genomics Consortium, an international network of scientists led by the Center for Genomics and Bioinformatics (CGB) at Indiana University (IU) Bloomington and the U.S. Department of Energy's Joint Genome Institute.
"Daphnia's ...
Wolverines threatened by climate change, earlier springs
2011-02-09
The aggressive wolverine may not be powerful enough to survive climate change in the contiguous United States, new research concludes.
Wolverine habitat in the northwestern United States is likely to warm dramatically if society continues to emit large amounts of greenhouse gases, according to new computer model simulations carried out at the National Center for Atmospheric Research (NCAR) in Boulder, Colo.
"The researchers have combined regional-scale climate projections with knowledge of a single species and its unique habitat to examine its vulnerability to a changing ...
Experimental approach may improve healing of diabetic wounds and bed sores
2011-02-09
MAYWOOD, Ill. -- Loyola University Health System researchers are reporting on a promising new approach to treating diabetic wounds, bed sores, chronic ulcers and other slow-to-heal wounds.
It may be possible to speed healing by suppressing certain immune system cells, researchers wrote in the February, 2011, issue of the journal Expert Review of Dermatology.
The cells are called neutrophils and natural killer T (NKT) cells. These white blood cells act to kill bacteria and other germs that can infect wounds. NKT cells also recruit other white blood cells to the site ...
Elder law expert: Health care reform act a mixed bag for seniors
2011-02-09
CHAMPAIGN, Ill. – Although the effects of the controversial health care reform act will be somewhat muted for many older Americans, it will inevitably have enough of an impact that seniors will discover that there is plenty to like and dislike about the law, a University of Illinois expert on elder law cautions in published research.
Law professor Richard L. Kaplan says the virtues of the Patient Protection and Affordable Care Act of 2010 are a "mixed bag," and how it will affect any one person depends on that person's specific situation.
"You have to expect some negative ...
Lack of sleep found to be a new risk factor for colon cancer
2011-02-09
An inadequate amount of sleep has been associated with higher risks of obesity, heart disease, diabetes, and death. Now colon cancer can be added to the list.
In a ground-breaking new study published in the Feb. 15, 2011 issue of the journal Cancer, researchers from University Hospitals (UH) Case Medical Center and Case Western Reserve University School of Medicine, found that individuals who averaged less than six hours of sleep at night had an almost 50 percent increase in the risk of colorectal adenomas compared with individuals sleeping at least seven hours per night. ...
Income inequalities are increasing the occurence of depression during financial crisis
2011-02-09
Due to the recent economic crisis, an increase of health inequalities between socio-economic groups has been noticed in both developed and developing countries.
The World Health Organization, the World Bank and the United Nations Development Programme have all reported these inequalities and emphasized its importance and made this issue a priority.
There is evidence that such inequalities not only affect general health, but have a particular impact on mental health.
A new study, published in World Psychiatry, the official journal of the World Psychiatric Association ...