Descriptive findings on FEHB plans’ parity implementation were obtained using data for two time periods (pre- and post-parity) from the Parity Reporting Requirement (PRR), which was completed by all FEHB plans that remained in the FEHB Program continuously from 1999 to 2002. 37 Findings on FEHB plans’ benefit design changes in response to the
Implementation of the Parity Policy
Key Implementation Research Questions
Did all FEHB plans comply with the parity policy?
How did the FEHB parity policy affect MH/SA benefit design and management?
How did the FEHB parity policy affect the benefit design and management for general medical care?
Did FEHB plans incur additional expense
This chapter summarizes the evaluation’s major findings on the implementation and impact of the parity policy on mental health and substance abuse (MH/SA) service utilization, cost, and quality. We first present a brief overview of the evaluation’s key research questions and findings. We then highlight the main findings on implementing the FEH
The PERT studied the effect of parity on quality of care for adults by using established standards of care for treating specific disorders, i.e., depression and substance abuse, to create indicators of quality following the methods developed by several investigators (c.f. Berndt et. al 1997; Lehman and Steinwachs, 1998). The methods described in t
Implementing parity required changing the nominal benefits for coverage of treating mental health and substance abuse (MH/SA) disorders. The dimensions of the nominal benefit that are most often affected when parity policies are implemented are:
This chapter addresses the intermediate and long-term impacts of the parity policy on access to care, service use, cost, and quality of care, as illustrated in the evaluation logic model in Figure II-I. The research questions, data sources and collection methods, and analysis methods relating to cost, access, utilization, and quality that we summa
All FEHB plans complied with the parity policy. No plan left the FEHB Program to avoid implementing the parity policy, and plans enhanced their MH/SA nominal benefits as required by the policy change. According to most (two-thirds) of the FEHB plans, they incurred no added administrative cost in implementing the parity policy.
Provider focus groups were conducted to assess providers’ awareness and perceptions of the parity benefit implementation. Each focus group was audiotaped and verbatim transcripts prepared from these tapes. The transcripts were then systematically analyzed for key themes.
Key Research Questions
PERT researchers developed a discussion guide fo
Using case study methods, PERT investigators characterized the structure and process employed by OPM and each of the eight selected plans to implement the FEHB Program parity requirement. The case studies focused on effective as well as nominal benefits, and described:
PERT researchers acquired nominal plan benefits information on the 304 FEHB plans with available benefit design information and participating in the FEHB in 1999, the baseline year of the evaluation. This information was obtained from the OPM website for all four years of the evaluation (1999-2002).
To compile information on benefits in each of
As part of the Office of Personnel Management’s (OPM’s) contract with the FEHB plans, each health plan was required to submit to the OPM a report on implementing mental health and substance abuse (MH/SA) parity in the first quarter of 2002 and in the first quarter of 2003. 12 The report, The Parity Reporting Requirement (PRR), designed by P
This chapter examines the implementation of the parity policy in the FEHB Program in terms of its effect on nominal and effective plan benefits, as illustrated in the evaluation logic model shown in FigureII-1. The research questions, data sources and collection methods, and analysis methods--summarized in the “Benefits” panel of Table II-1--a
The study design included selecting a small number of plans for in-depth study, i.e., obtaining archival claims data, conducting plan site visits, and conducting focus groups with providers (from a subset of the selected plans). Plans were selected on the basis of various characteristics on which they were likely to differ:
The design of the evaluation was quasi-experimental. Plan data on nominal benefits (for all FEHB plans) and archival (claims) data on access, utilization, and cost (for nine selected plans) were studied before and after the implementation of parity.Changes in these measures were compared to changes in matched non-FEHB comparison group plans from t
The study’s key research questions are described in Table II-1 and reflect the logic model in Figure II-1. Table II-1 identifies the data sources and collection methods most relevant to each research question. chapter III, Implementation of Parity , and chapter IV, Impact of Parity , provide further details on more specific research questions,
The logic model for understanding the relationship between implementing benefit changes and new methods for managing care and their impact on access, utilization, cost, and quality appears in Figure II-1. The logic model provides a framework for the evaluation. It depicts a sequence of moves from implementing the policy of the President to have al