Outpatient Services Experience Big Decline In Availability According To New Study
The report cites "managed behavioral healthcare" benefit trends toward low reimbursement rates and shortened hospital lengths of stay as leading psychiatric hospitals to adopt policies geared toward rapid stabilization and early discharge. NAMI's managed care report card released in 1997, "Stand and Deliver: Action Call to A Failing Industry," documented the failure of managed behavioral healthcare to deliver on many needs of people with severe mental illnesses, including flexible hospital length of stay and discharge planning. NAPHS concludes that hospital services are increasingly focusing on discharging patients as soon as they are stabilized. This has in turn added to the high demand for outpatient services and the inability of outpatient services providers to keep pace.
A 1999 study by the Hay Group that examined behavioral healthcare trends over a ten year period found that the value of behavioral healthcare benefits has declined 54 percent from 1998 to 1997. That study, commissioned by NAPHS, NAMI and the Association of Behavioral Group Practices (ABGP), showed that resources desperately needed by those with serious brain disorders were being eliminated. For example, the number of plans with annual visit limits for outpatient behavioral health care has nearly doubled. In 1997, 48 percent of plans imposed annual visit limits for outpatient behavioral health care compared to just 26 percent in 1988, according to the Hay Group report. By 1997, the most prevalent limit was 20 outpatient visits. By contrast, 46 percent of the plans that imposed a visit limit in 1988 allowed a maximum of 50 visits. This most recent study found that only 17 percent allow 50 visits.
Taken together these reports clearly suggest that once again individuals with serious brain disorders, and their families, who most need access to effective treatments are seeing the value of their benefits erode. Moreover, it is equally clear that these savings have not been used to increase the availability of behavioral healthcare services, including outpatient services.
The following are among the other findings of the 1999 NAPHS survey:
Additional information can be found on the NAPHS survey at http://www.naphs.org