VITAL STATISTICS

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 seniors? Complete data for those groups going back to 1997 apparently weren’t available. But MEPS does paint a fairly comlpete picture for 2007:

l About 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%.

l About 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 sources--11.1%.