Background / Our Implementation / Costs / Deductibles / Standard Coverage / Coverage Requirements / Medicare / Regulations / Disclaimer

Costs

What is parity going to cost?

Studies indicate that overall claims cost changes resulting from the new federal parity legislation may be as low as 0 percent to 2 percent. The GAO in estimating the cost of current parity legislation estimated impact at 0.4 percent¹ Given the existence of state parity and associated cost, some of the estimated cost may have already been absorbed.

What recommendations is Aetna making to help plan sponsors limit the cost increase of compliance?

The enactment of the MHP Act will not require compromise or elimination of the effective case management and utilization management processes currently in place. These practices have been proven to control costs associated with unnecessary behavioral health care. We will continue to use utilization review and medical management including the application of medical necessity criteria in making quality treatment and care determinations.

We also recommend that plan sponsors provide information to members regarding the value of in-network usage and higher costs that may result from out-of-network usage. Additionally, we advise that plan sponsors begin to review and refine the in- and out-of-network components of their plan designs to meet the requirements of the MHP Act. Aetna will continue to provide utilization management services in conjunction with all in-network and out-of-network inpatient behavioral health services, as well as intermediate levels of care, including partial hospitalization and intensive outpatient programs as part and parcel of the program.

1. Mays, J. Growth in Premiums in the FEHBP from Mental Health Parity. U.S. Department of Health and Human Services. May 20, 2005. Available at: http://aspe.hhs.gov/health/Reports/05/mhsamemo.htm. Accessed March 5, 2009.