Mental health coverage not costly under managed care.

An examination of data from health care plans that provided generous benefits for mental health and substance abuse services found that the use and cost of such services did not increase significantly, provided the benefits were offered under so-called managed care plans.

The study looked at seven health plans covering government workers from 1999 to 2002. Each of the plans provided coverage for mental health and substance abuse services comparable to that for other health conditions, a concept known as "parity." Researchers found that the rates of spending on, and use of, mental health and substance abuse services rose during the three-year period, but no more so than in private health plans offering minimal mental health benefits.

In five of the seven government health care plans, moreover, enrollees saw their out-of-pocket costs for mental health care services decrease, from $14 to $87 per year. Those five plans were managed care plans rather than traditional fee-for-service plans.

The study provides ammunition for advocates of parity, who say it would eliminate the insurance industry's longstanding bias against people with mental illness. Insurance providers and business groups strongly oppose parity requirements, saying they would increase insurance premiums or force some employers to reduce coverage for physical ailments.

The study is published in the March 30 New England Journal of Medicine.