A newly formed trade association has released figures showing that a mental health benefit won't cost the nation nearly as much as the Clinton administration has estimated.
The figures are based on data compiled by 15 firms that have formed the American Managed Behavioral Healthcare Association. The new group's members manage mental health and substance-abuse treatment for about 65 million Americans. In most cases, the companies contract with corporations or local governments to provide behavioral health benefits as a separately managed benefit.
The Clinton administration has estimated that a mental health benefit would cost $259 per person per year. That benefit would include 30 days of inpatient care, 30 outpatient visits with a 50% copayment, and 120 days of partial, ambulatory detoxification or home-based services.
According to AMBHA's study, the cost of a managed behavioral health benefit is $87 per person per year. That contrasts with $141 per year for a similar commercial population in the Clinton administration plan. The overall $259 estimated for the Clinton plan includes other more costly groups, such as the seriously mentally ill, that would be included under universal coverage.
AMBHA's estimate is lower because it believes that managing the benefit would bring the cost down substantially. The AMBHA figures also include Medicaid populations, which the group estimates at $55 per person per year when managed through health maintenance organizations.
The figures are the first compiled by the industry to show a composite of what a managed behavioral healthcare benefit costs businesses.
"This study shows that the cost of substantial mental healthcare and drug and alcohol treatments are reasonable and controllable if they are delivered through high-quality managed-care plans," said Alan Shusterman, the group's chairman.
The group contends that by managing mental health through a continuum of care that uses the least costly but most appropriate providers, significant savings can be achieved. For example, AMBHA estimates savings of 25% to 30% by reducing medically unnecessary treatment.
Armed with such data, mental health advocates hope to convince Congress not to limit psychiatric services by implementing what they view as arbitrary limits on the number of days of treatment. They also argue that a mental health benefit that's properly managed can be less costly.
Mental health executives are fighting some business groups that want to drop a behavioral health benefit from any health reform bill.
The Alexandria, Va.-based group has presented its findings to the administration, HCFA, the Congressional Budget Office and congressional representatives, including Rep. Jim Cooper (D-Tenn.), whose managed-competition bill has garnered bipartisan support. However, unlike the Clinton health reform plan, Mr. Cooper's bill doesn't specifically address mental health benefits.