The Mental and Nervous Disorder Utilization and Cost Survey in
Washington, D.C., has yielded useful information about outpatient
utilization within an insurance plan with broad mental health coverage, as
well as evidence that a comprehensive benefit with a low deductible and
copayment can be offered and reasonably utilized. From the results of this
survey and a substudy of claims made during 1977, the authors conclude that
psychiatric diagnostic information submitted on insurance claim forms may
often be inaccurate, primarily because of providers' concerns about
confidentiality; such information is of little use for peer review or
claims review. The authors state that caution must be exercised in
generalizing from the experience under this plan to speculate about
outpatient utilization which might result from broad coverage on a national
level.
Abstract Teaser