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Effects of the Vermont Mental Health and Substance Abuse Parity Law
Exhibit 1.3: Questions Addressed by the Evaluation of the Vermont Parity Law
Implementation Process
- What mandates governed mental health/substance abuse (MH/SA) benefits
prior to parity? What were the specific benefits and benefit limits for MH/SA for a typical health plan prior to the law? What specifically does the
Vermont parity law require? What activities have taken place among the major
stakeholders to implement, coordinate, and ensure compliance with the parity
law? What obstacles, if any, were encountered? What modifications or clarifications
were made during implementation? Do stakeholders feel that the law has achieved
its objectives? If not, why not?
Health Plan Issues
- How has the parity law affected the scope of MH/SA coverage offered by
health plans (for example, benefits and benefit limits)? Has the parity law
affected the number of insurers in Vermont, especially in the individual and
small group markets? Has the parity law affected the number of insurance products
offered by Vermont insurers? How has implementation of the parity law varied
among health plans (use of managed care, MH/SA carve-outs, utilization management,
provider networks)?
Employer Issues
- What were employer responses to parity? Have employers responded to the
parity mandate by increasing employee premiums, dropping coverage or benefits,
or converting to self-insured plans? How do employer responses vary among
small, medium, and large businesses? Have there been any effects on employers
not subject to the mandate? How satisfied are employers with the parity law,
and what recommendations do they have for improving the law in the future?
Provider Issues
- Has the parity law led to changes in how health plans contract with MH/SA providers? Has the parity law affected the mix of providers with which
health plans contract? Has the parity law led to changes in how health plans
reimburse MH/SA providers?
Consumer Issues
- Who provided consumer education about the changes brought about by the parity
law? How knowledgeable are consumers about the parity provisions? How do consumer
advocates view the results of the law, especially regarding consumer access
to MH/SA services? Were there any unintended consequences?
Health Care Access, Utilization, and Spending
- How have access, utilization, and spending changed as a result of parity
(such as percentage of covered population receiving any MH/SA service, intensity
of care, MH/SA costs per covered life)? What types and amounts of services
utilized post-parity would not have been covered pre-parity? Have characteristics
of utilization changed following the implementation of parity? Who specifically
is better off as a result of the law?
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