Here’s some valuable national context for a hot local struggle over inpatient detox beds.
The local news, from the Boston Globe yesterday:
Brigham and Women’s Faulkner Hospital is modifying its plan for closing an inpatient drug and alcohol detoxification unit, after the proposal drew heavy criticism from patients, hospital staff, and mental health advocates who said the state has too few such specialized facilities and the change could harm patients.
“Sure,” I thought when I saw that. “Those attempted cuts fit with all you hear about mental health care as the neglected stepchild of other medical care, and substance abuse as the even more neglected stepchild of mental health care.”
But that’s just my lazy, impressionistic thinking. The quants with hearts over at the Health Care Cost Institute have just used their monumentally huge data sets of tens of millions of insurance claims to pin down what’s been happening lately with inpatient substance abuse payments. And I’d say they, too, found a certain stepchild factor, at least in terms of what patients must pay out of pocket.
Their new report says, according to the press release:
In 2011, out-of-pocket payments for mental health admissions more closely aligned with payments for medical/surgical admissions. However, the amount spent out-of-pocket on substance use admissions remained higher than payments for medical/surgical admissions. Out-of-pocket payments for substance use hospital admissions grew at twice the rate of out-of-pocket payments for mental health or medical/surgical admissions between 2010 and 2011.
The report also found that rates of inpatient detox had taken a major jump after the federal “parity” law, requiring health insurers to cover mental health similarly to physical health, kicked in: Continue reading