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生育情况与联邦雇员健康福利计划(FEHB)中网络外心理健康福利的使用

Parity and the use of out-of-network mental health benefits in the FEHB program.

作者信息

Regier Darrel A, Bufka Lynn F, Whitaker Tracy, Duffy Farifteh F, Narrow William E, Rae Donald S, Reed Geoffrey M, Rehman Omar F, Rubio-Stipec Maritza, Weismiller Toby, Wilk Joshua E, West Joyce C

机构信息

American Psychiatric Institute for Research and Education, Arlington, Virginia, USA.

出版信息

Health Aff (Millwood). 2008 Jan-Feb;27(1):w70-83. doi: 10.1377/hlthaff.27.1.w70. Epub 2007 Dec 18.

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.

摘要

两项现行国会法案规定,在提供心理健康福利时,私人保险中精神障碍福利应与医疗/外科疾病福利享有同等地位;这两项法案在福利水平和非网络覆盖范围方面存在差异。本研究评估了在联邦雇员健康福利(FEHB)同等地位计划下,首都地区临床医生和受益人的管理式医疗网络参与情况。约三分之一接受研究的临床医生参与了FEHB网络,且只有44%的FEHB患者接受网络临床医生的治疗。非网络心理健康福利是确保在同等地位提议下能够获得心理健康治疗的一项重要政策考量。

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