U.S. medical and mental health benefits may be starting to come together.
The Disability Management Employer Coalition (DMEC) has included data on how employers provide behavioral health benefits in its latest behavioral risk survey. DMEC employers online, in the summer of 2014, and received 314 responses. About 87 percent of the responses came from employers with more than 1,000 employees.
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) does not require any employer to offer behavioral health benefits. The MHPAEA does require a “large employer” that offers both behavioral health benefits and medical benefits to provide parity between the behavioral health benefits and the medical benefits. For MHPAEA purposes, the large-employee cut-off is 51 employees in some states and 101 employees in others.
The U.S. Department of Health and Human Services (HHS) has ruled that small-group plans must normally offer the full Patient Protection and Affordable Care Act (PPACA) essential health benefits package, which includes mental health and substance abuse benefits.
The PPACA small-group rules have had no direct effect on most of the employers in the DMEC sample, but analysts found that only 12 percent offer behavioral benefits through a separate carve-out plan. That’s down from 17 percent in 2012 and from 20 percent in 2010.
Most of the other employers provide behavioral health benefits through their health plans.
The increased integration of behavioral health benefits with other health benefits may be due partly to traditional insurers’ growing ability to offer strong behavioral health programs, but it may also be due to behavioral and medical health parity efforts, DMEC says.
DMEC also looked at topics such as how employers screen for behavioral health problems that may lead to disability.
A little more than one-third of the employers screen for stress or substance abuse, and almost one-third screen for depression.
About 55 percent said they do not screen at all for stress, anxiety, substance abuse or depression, and 64 percent said they identify “at risk” employees mainly by waiting for employees to report having problems or file behavioral health-related insurance claims.