PAST-YEAR CHANGES:
The Hay Group Study on Health Care Plan Design and Cost Trends - 1988 through 1998Released April 1999
BENEFIT DESIGN
Behavioral healthcare benefit costs in the past year (1997-1998) have decreased 1.5%. The value of behavioral healthcare benefits (in constant 1998 dollars) decreased from $70.96 per covered individual in 1997 to $69.87 in 1998.
Behavioral health care as a proportion of the total value of employer-provided health care benefits stabilized, going from 3.1% of the total in 1997 to 3.2% in 1998.
INPATIENT
The percentage of plans imposing any type of limit on inpatient psychiatric care increased, from 86% of plans in 1997 to 88% of plans in 1998.
OUTPATIENT
The percentage of plans imposing an annual visit limit on outpatient care rose, from 48% of plans in 1997 to 57% of plans in 1998. (One explanation may be that plan designs have been modified to offset the costs of compliance with the Mental Health Parity Act, although no supporting data are yet available.)
There is a growing trend of providing outpatient psychiatric care with a separate per visit copayment (done by 39% of plans in 1998, compared to 35% of plans in 1997) as opposed to providing these benefits under the general medical plan deductible (done by 35% of plans in 1998, compared to 38% of plans in 1997).
MUTUAL OF OMAHA CASE STUDY
Each year Mutual of Omaha produces a report based on a sample of their group business and the actual experience of their policy holders. The policies included represent a mixture of groups with and without managed care features. Hay has found that the Mutual of Omaha reports reflect national trends. In their study ("Current Trends in Health Care Costs and Utilization"), Mutual of Omaha found the following:
Outpatient psychiatric encounters per 1,000 people were stable, at 285 encounters/1,000 in both 1996 and 1997 in the Mutual of Omaha experience.
The average charge per outpatient psychiatric encounter (in 1998 dollars) increased one percent, from $94 in 1996 to $95 in 1997 in the Mutual of Omaha experience.
Inpatient admissions per 1,000 people were down 2.8%, from 3.5 admissions/1,000 in 1996 to 3.4 admissions/1,000 in 1997 in the Mutual of Omaha experience.
Average inpatient length of stay for mental and behavioral disorders was down 5.8%, from 8.5 days in 1996 to 8 days in 1997 in the Mutual of Omaha experience.
Inpatient days per 1,000 people for mental and behavioral admissions were down 6.8%, from 29 days/1,000 in 1996 to 27 days/1,000 in 1997 in the Mutual of Omaha experience.
HISTORIC CHANGES:
Behavioral
healthcare benefit costs in 11 years (1988-1998) have decreased more
than general healthcare benefit costs. Where the value of general
healthcare benefits has declined 11.5% (from $2,372.01 per covered individual
in 1988 to $2,098.68 in 1998), the value of behavioral healthcare benefits
has declined 54.7% (from $154.48 in 1988 to $69.87 in 1998). All values
are in constant 1998 dollars.
Behavioral
health as a percent of the total healthcare benefit has plummeted 50%
in 11 years (dropping from 6.1% in 1988 to 3.2% in 1998). Although
there is a slight (0.1%) increase in the proportion of employer healthcare
dollars attributed to behavioral health care from 1997 to 1998, the
value of behavioral health benefits remains significantly below the
1988 level.
The
value of behavioral health care benefits (in constant 1998 dollars)
decreased in each of the past 11 years (dropping from $154.48 in
1988 to $69.87 in 1998).
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