Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Goals and Objectives of the Evaluation

12/31/2004

The Federal Employees Health Benefits (FEHB) Program evaluation addressed changes in cost, access, utilization, and quality as a result of the parity policy. Additionally, the evaluation focused on adverse selection arising from the managed competition that exists in the FEHB Program. Adverse selection refers to the tendency for individuals to choose insurance plans whose benefits will cover services that they expect to use. For example, people with mental health and substance abuse (MH/SA) conditions tend to select health plans with more generous MH/SA coverage.

The overall goals of the evaluation were to examine both the implementation of the parity requirement for FEHB plans and the intermediate and long-term impacts of the FEHB parity policy on the FEHB plans.

The objectives of this evaluation were to:

  • Assess the degree to which the parity requirement affects
    • benefit design and management;
    • access to MH/SA services;
    • utilization of MH/SA services;
    • costs to beneficiaries, plans, and Office of Personnel Management (OPM);
    • quality of MH/SA services; and
    • providers’ awareness and perceptions of the policy change.
  • Examine the patterns in these effects across subgroups of plans and providers.
  • Assess the interrelationships among changes in
    • benefit design and management,
    • costs,
    • access,
    • utilization, and
    • quality.

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