Changes in the health care system make it necessary to regularly update our knowledge of how services for drug use disorders are provided. It is particularly important in the current environment because of the recent passage of federal parity legislation which requires group health plans offering mental health/addiction services to cover these services in a comparable manner to medical/ surgical services, effective January 1, 2010 for most health plans. Building on two previous rounds of our health plan survey, we propose to (1) enhance the """"""""core"""""""" third round planned for 2010 by adding specific questions on drug abuse treatment and an in-depth module on parity, and (2) conduct a follow-up survey in 2012 focused on health plan response after final parity regulations have been issued and the 2011 cost opt-out provision is finished.
The specific aims are: * Describe the provision of services for drug use disorders in private health plans in terms of administrative and clinical factors by enhancing a survey for benefit year 2010 to specifically focus on drug abuse services and analyze changes in health plans'provision of these services in the last decade by comparing to previous rounds of the survey in 1999 and 2003. * Study health plans'specific responses to the implementation of federal parity legislation on January 1, 2010 with an in-depth analysis of changes that were specifically adopted because of parity, by enhancing the 2010 survey through a special module on parity. * Study health plans'further responses to federal parity legislation in benefit year 2012, following both the requirement that all plans opting out in 2011 participate in 2012 and the issuance of clarifying final regulations expected to go into effect in 2011. * Model changes from benefit year 2010 to 2012 in health plans'implementation of parity, reflecting changes in response to parity regulations and the cost opt-out provision. The proposed study of drug treatment services will combine the 1999, 2003, and the 2010 rounds and the 2012 parity follow-up of our nationally representative health plan survey in a prospective design that will allow us to track how the delivery of drug services evolves within the changing health care market. It will specifically focus on issues related to federal parity, particularly health plan response in light of regulations and cost opt- out provisions.

Public Health Relevance

Changes in the health care system, such as parity due to federal legislation, make it necessary to regularly update our knowledge of how drug abuse services are provided. Health plan decisions can influence not only whether there is recognition of a problem, but also patients'access to care, and the quality and cost of care they receive. The enhancement of our 2010 health plan survey and the 2012 parity follow-up survey will provide a current picture of the complex and changing organization of drug abuse treatment services in private health plans, which cover the majority of people under 65 in the U.S.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZDA1)
Program Officer
Duffy, Sarah Q
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Brandeis University
Schools of Social Welfare/Work
United States
Zip Code
Stewart, Maureen T; Horgan, Constance M; Hodgkin, Dominic et al. (2018) Behavioral Health Coverage Under the Affordable Care Act: What Can We Learn From Marketplace Products? Psychiatr Serv 69:315-321
Garnick, Deborah W; Horgan, Constance M; Merrick, Elizabeth L et al. (2017) Private Health Plans' Contracts with Managed Behavioral Healthcare Organizations. J Behav Health Serv Res 44:149-157
Reif, Sharon; Creedon, Timothy B; Horgan, Constance M et al. (2017) Commercial Health Plan Coverage of Selected Treatments for Opioid Use Disorders from 2003 to 2014. J Psychoactive Drugs 49:102-110
Stewart, Maureen T; Horgan, Constance M; Quinn, Amity E et al. (2017) The Role of Health Plans in Supporting Behavioral Health Integration. Adm Policy Ment Health 44:967-977
Quinn, Amity E; Reif, Sharon; Merrick, Elizabeth L et al. (2017) How Do Private Health Plans Manage Specialty Behavioral Health Treatment Entry and Continuing Care? Psychiatr Serv 68:931-937
Quinn, Amity E; Reif, Sharon; Evans, Brooke et al. (2016) How health plans promote health IT to improve behavioral health care. Am J Manag Care 22:810-815
Horgan, Constance M; Stewart, Maureen T; Reif, Sharon et al. (2016) Behavioral Health Services in the Changing Landscape of Private Health Plans. Psychiatr Serv 67:622-9
Horgan, Constance M; Hodgkin, Dominic; Stewart, Maureen T et al. (2016) Health Plans' Early Response to Federal Parity Legislation for Mental Health and Addiction Services. Psychiatr Serv 67:162-8
Reif, Sharon; Horgan, Constance M; Hodgkin, Dominic et al. (2016) Access to Addiction Pharmacotherapy in Private Health Plans. J Subst Abuse Treat 66:23-9
Merrick, Elizabeth; Hodgkin, Dominic; Horgan, Constance et al. (2015) Employee assistance programs in private health plans: what do they offer? Psychiatr Serv 66:220

Showing the most recent 10 out of 13 publications