AMBHA Reports & Studies:Cost Reports


Directory of AMBHA Reports, Studies and Publications (as of December 1999):
	Cost Reports Use of Managed Behavioral Healthcare in the Public Sector The Regulation of Managed Care Quality Assurance The Managed Behavioral Healthcare Industry Statements on Public Policy Issues Code of Conduct Litigation Update

Cost Reports

"Managed Behavioral Healthcare Cost Report"
Prepared for AMBHA by Milliman and Robertson, Inc., January 26, 1994. The report provides cost data for the commercially insured population. The report documents that the nation expended $3.045 billion for 35.4 million covered lives, or $87 per person per year. The report concludes that there are dramatic savings in costs in a fully managed behavioral healthcare system as compared to a less managed fee-for-service system. The report documents that the nation expended $139 per person per year for 13.2 million covered lines enrolled in managed indemnity plans.
Cost: $20.00, check payable to AMBHA.

"Managed Behavioral Healthcare Cost Report for the Commercial Insured and Uninsured Populations" Prepared for AMBHA and the National Association of State Mental Health Program Directors (NASMHPD) by Milliman and Robertson, Inc., May 13, 1994. The report offers estimates for health benefit plan designs based on the actual expenditure experience of 14 AMBHA member companies for the commercially insured population and of 22 states which combined both the state mental health and state Medicaid mental health expenditures. The report concludes that, using the Clinton Administration proposed national health care reform benefit for mental health and substance abuse and applying it within a managed behavioral system, estimated costs would be: for the insured population: $88 per person per year for the Medicaid population: $168-335 per person per year for the uninsured population: $430-490 per person per year
Cost: $20.00, check payable to AMBHA.

"The Impact of Managed Behavioral Healthcare on the Costs of Psychiatric and Chemical Dependency Treatment."
A Behavioral Healthcare Tomorrow reprint, March/April 1994. A summary of the Milliman and Robertson AMBHA cost study.
Cost: $5.00, check payable to AMBHA.

"The Costs of Non-Discriminatory Health Insurance Coverage for Mental Illness" and "Premium Rate Estimates for a Mental Illness and Substance Abuse Parity Provision"
Prepared in April 1996 for the Coalition for Fairness in Mental Illness Coverage (AMBHA, American Psychiatric Association, NAMI, NAPHS, and NMHA) by the actuarial consulting firm of Milliman and Robertson, two reports estimate the effects of nondiscriminatory healthbenefit plan coverage for the treatment of mental illness. The first report estimates the effect on premium rates for commercial health insurance products for non-discriminatory coverage provisions for severe mental illness. Using a PPO plan model, the estimate is that plan costs would increase by 2.5%. The second report estimates the effect on per capita premium rates for commercial health insurance products resulting from nondiscriminatory coverage of mental illness (3.2% cost increase) and mental illness and substance abuse (3.9% cost increase).
Cost: $30.00, check payable to AMBHA.

"Premium Rate Estimates for Parity Mental Illness Insurance Coverage for Children."
Prepared June 20, 1997 for the Coalition for Fairness in Mental Illness Coverage (AMBHA, both APAs, AMA, FAHS, NAMI, NAPHS, and NMHA) by the actuarial consulting firm of Milliman and Robertson, the report estimates the impact on premiums of requiring parity for mental illness health plan coverage for children. Using a FEHBP standard BC/BS baseline and a tightly managed benefit, the premium increase would be 1.9%. Using the State of Washington Basic Health Plan baseline and a tightly managed benefit, the premium increase would be 0.3%.
Cost: $10.00, check payable to AMBHA.

"Premium Estimates for Substance Abuse Parity Provisions for Commercial Health Insurance Products"
Prepared in September 1997 for the Coalition for Nondiscriminatory Coverage of Addiction Treatment (AMBHA, ASAM, LAC, NAATP, NAADAC, NAPHS, NMHA, and PFR) by the actuarial consulting firm of Milliman and Robertson, the report estimates the effects of nondiscriminatory health plan coverage for the treatment of addictive diseases. Estimated premium increases for full parity are PMPM $1.35 in FFS, $0.56 in PPO/POS, and $0.1% in HMO/MCO. The composite estimated premium increase would be $0.66.
Cost: $20.00, check payable to AMBHA.

"Value of Benefits Offered In Benchmark Plans for State Children's Health Insurance Program (SCHIP)"
Prepared November 1997 for the Coalition for Fairness in Mental Illness Coverage (AMBHA, AMA, both APAs, FAHS, NAMI, NAPHS, and NMHA) by the benefits consulting firm The Hay Group, the report documents the actual mental health benefits, and their actuarial value, of optional benchmark health plans required by SCHIP in 16 states. These 16 states comprise 63% of the nation's uninsured children and will receive 65.5% of the federal SCHIP funds. This is roughly a 150 page report plus AMBHA's November 18 summary. Also included is the February 1998 Behavioral Healthcare Tomorrow AMBHA article, "The Child Health Insurance Program ö Some Lessons for the Future."
Cost: $50.00, check payable to AMBHA.

"Establishing Capitation Rates"
Copies of 14 overhead slides presented to the National Mental Health Association State Executive Directors March 17, 1998 meeting, "Financial Issues in Managed Care Medicaid Programs."
Cost: $10.00, check payable to AMBHA.