Am J Psychiatry 1978; 135:315-319
Copyright © 1978 by American Psychiatric Association
Utilization and cost of mental illness coverage in the Federal Employees Health Benefits Program, 1973
EC Hustead and SS Sharfstein
The authors examine the utilization of mental illness benefits under the
Blue Cross/Blue Shield and Aetna plans for federal employees; the latter
plan sharply cut back its mental illness benefits in 1975. In 1973 mental
illness benefits represented 7.4% of all payments under the Blues plan and
12% under the Aetna plan. The benefit for mental illness treatment under
the Blues averaged $12.52 per person covered and was 7.3% of the total
benefits for all conditions. Younger enrollees and their spouses tended to
receive mental illness benefits primarily for outpatient treatment and
children and older adults for hospitalization. These data raise key
questions for claims review and peer review activities.
