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HCMG 1010, Exam 2
Mental and Behavioral Heathcare
| Question | Answer |
|---|---|
| How were mental health patients cared for before 1950s? | care primarily in institutions, paid for by public sector |
| What were psychiatric hospitals replaced with? | community based care |
| How did insurers think of mental health patients? | leads to demand for coverage for mental health services in private health insurance plans, but insurers afraid will increase costs, also fear for adverse selection |
| What was the result of how insurers reacted to covering mental health services? | coverage for treatment of mental illness substantially less generous compared to coverage for physical illness, requires higher cost sharing and limits |
| What are strong parity laws? | mandate mental health benefits, prohibit limits on visits/days, limit extent to which enrollees can be charged higher cost sharing for mental health services |
| What are the major concerns even in states with parity laws? | variation in how strong laws are, state parity laws do NOT apply to small firms/self insured firms |
| What did the Mental Health Parity and Addiction Equity Act enact in 2008? | create "parity" by eliminating historical differences in group health insurance coverage for mental health and substance abuse |
| How did employer coverage change from Mental Health Parity and Addiction Equity Act in 2008? | if employer offers behavioral coverage, cost sharing and treatment limits for MH/SA benefits must be EQUAL to those for medical/surgical benefits |
| Which plans did the Mental Health Parity and Addiction Equity Act affect? | ESHI plans, state and local government plans, does NOT extend to individual insurance market |
| How did the ACA affect mental health? | inclusion of mental health and substance abuse services as ESSENTIAL health benefits |
| Which plans did the ACA affect for mental health benefits? | plans available in the Marketplace and to fully insured small group and individual plans |
| Who were exempt from the mental health benefits requirement from the ACA? | self-insured and large-group plans are exempt from the requirement |
| How can insurers circumvent mental health parity mandates? | by imposing restrictive standards of medical necessity |
| What was the lawsuit in Wit v. United Behavioral Health? | whether an insurer's internal rules for approving mental-health care matched standard medical practice |
| What was the ruling in Wit V. United Behavioral Health? | judge rules that UBH wrote its guidelines for treatment much more narrowly than common, covering only enough care to stabilize patients while ignoring the effective treatment of members' underlying conditions |
| Which speciality is the least likely to take insurance, especially medicaid? | psychiatrists |
| Where does a large percentage of mental health treatment happen? | in primary care |
| What is one professional career that mental health treatment could broaden scope too? | nurse practitioners |
| What is did the Johnson Schurer and Shields study show? | data on 3 generations from the 1970 British Birth Cohort study, showed that bad for child's development if mother doesn't interact in crucla period with post-partum/maternal depression |
Created by:
goldengalleon