Mental Health Financing in the United States - A Primer - KFF

Mental Health Financing in the

United States

A Primer

APRIL 2011

The Kaiser Commission on Medicaid and the Uninsured provides information and analysis on health care coverage and access for the low-income population, with a special focus on Medicaid's role and coverage of the uninsured. Begun in 1991 and based in the Kaiser Family Foundation's Washington, DC office, the Commission is the largest operating program of the Foundation. The Commission's work is conducted by Foundation staff under the guidance of a bipartisan group of national leaders and experts in health care and public policy.

Mental Health Financing in the

United States

A Primer

APRIL 2011

Prepared by: Rachel L. Garfield Kaiser Commission on Medicaid and the Uninsured

Table of Contents

Executive Summary..................................................................................................................... i

I. Introduction .............................................................................................................................. 1

II. Overview of Behavioral Health Care ..................................................................................... 1 Prevalence of Behavioral Health Problems............................................................................... 1 Behavioral Health Services and Utilization................................................................................ 2

III. Sources of Financing for Behavioral Health Care .............................................................. 5 Public Sector Financing............................................................................................................. 5 Medicaid............................................................................................................................ 6 Medicare ........................................................................................................................... 9 Other Public Programs.................................................................................................... 10 Private Sector Financing ......................................................................................................... 11 Private Insurance Coverage ........................................................................................... 11 Out-of-Pocket Payment................................................................................................... 13 Other Private Sources..................................................................................................... 14 Interaction between Financing Sources .................................................................................. 14 Public-Private Interactions .............................................................................................. 14 Public Payer Interactions ................................................................................................ 15 Behavioral Health and Social Services Interactions ....................................................... 16

IV. Spending on Behavioral Health Care ................................................................................ 17

V. Recent Policy Issues in Financing Behavioral Health Care ............................................. 19

VI. Conclusion ........................................................................................................................... 22

Tables ........................................................................................................................................ 23

Endnotes ................................................................................................................................... 26

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