How many people get MH treatment, and
what does it cost?
We hear this question all the
time. Unfortunately, when we go looking for answers, the agencies that
ought to know appear to have based their work on guesstimates or
conjecture. But recently, we’ve reviewed several reports that seem
based on a more realistic approach. From what we can tell, the figures
in the table, at the end of the article, are at least in the ballpark.
These numbers reflect the
change in utilization and cost for substance abuse and mental health
services for adults (age 18-64) between 1997 and 2007. Numbers are
drawn from research produced by the "Medical Expenditure Panel
Survey" (MEPS) based on regular surveys of the public. (In other
words, this is not insurance industry data.)
How was this treatment paid
for? It breaks down
like this: private insurance--33%; Medicaid--20.8%;
out-of-pocket--20.6%. The remaining 25.4% was paid for by a wide
variety of federal, state, local and private sources.
What about children and
data for those groups going back to 1997 apparently weren’t
available. But MEPS does paint a fairly comlpete picture for 2007:
4.4 million children and adolescents in the U.S. received some
form of MHSA service in 2007--that was about 5.9% of all under-18s.
The payment breakdown was: Medicaid--44.7%; private insurance--31.4%;
out-of-pocket--14.0%; other sources--9.9%.
1.1 million seniors received MHSA services in 2007. The payment
breakdown was: Medicare--61.7%; Medicaid--18.2%; out-of-pocket--1.5%;
private insurance--0.1%; and other sources--18.5%. Remember that a
significant number of over-65s have dual eligibility and are covered
both by Medicare and other sources of funds.
According to the MEPS data,
the total number of Americans (children, adults, and seniors)
receiving MHSA services in 2007 was 35.4 million. That’s about 11.7%
of the population--which was an estimated at 301.6 million that year.
The biggest payer overall was private insurance--27.1%; then
Medicare--23.5%; Medicaid--20.6%; out-of-pocket--17.7%; and other
Data was drawn from the "Medical Expenditure Panel Survey
Household Component (MEPS HC), www.meps.ahrq.gov/mepsweb; and from 2)
a report by the Agency for Healthcare Research and Quality (AHRQ)
based on the MEPS data--see AHRQ at www.ahrq.gov; and 3) a
report by Open Minds--a Gettysburg, PA, publishing company that does
research and analysis in the behavioral health field. See them at