Cost to Beneficiaries Declined

Costs for MH/SA services increased in FEHB plans, but the increases were similar to changes in plans provided by large employers who offered MH/SA but did not provide parity.

Access to and utilization of MH/SA services also increased at a rate similar to increases in the comparison group of large employers that offered MH/SA parity benefits but did not offer parity with other benefits.

Out-of-pocket costs for MH/SA services declined more for FEHB beneficiaries than for those in the comparison plans.

Two-thirds of the FEHB plans incurred no additional administrative costs due to the parity mandate.

There was no evidence that FEHB plans changed benefits for general medical services as a result of the mental health parity policy.

For major depressive and substance abuse disorders, the two types of disorders studied, there was little or no effect on quality of care in the FEHB plans.

All FEHB plans complied with the MH/SA parity policy, and none refused to participate. Before implementation of the parity policy, 98 percent of the participating plans contained at least one benefit feature that was more restrictive for MH/SA treatment than for general medical care and thus had to be changed to comply with the policy.

FEHB plans showed a greater use of carveout vendors after implementation of the parity policy. Requirements for submission of treatment plans increased, but other managed care techniques, such as gatekeeper requirements, did not.