IOM Says Cost Should Trump Comprehensiveness in New Insurance Plans

The Institute of Medicine (IOM) is urging the government in a report released Thursday to consider cost as a key factor when it determines what an essential health benefit package looks like in insurance plans offered under the new health reform law. In the report, "Essential Health Benefits: Balancing Coverage and Cost," the IOM offers seven criteria for determining a benefit package. It says in the aggregate a benefit package must: be affordable; maximize the number of people with insurance; protect the most vulnerable; encourage better care practices; advance stewardship of resources; address the medical concerns of greatest importance; and protect against the greatest financial risks. A danger of this approach is that benefits packages could be modeled on those offered by smaller employers, who often provide more limited mental health coverage than large companies do.

APA has a guide to key aspects of the health reform law titled "Health Care Reform: A Primer for Psychiatrists," which is posted at www.appi.org/SiteCollectionDocuments/Journals/PSY/HealthCareReform.pdf.
Read more about how the reform law is changing psychiatric practice in Psychiatric News at http://pn.psychiatryonline.org/content/46/6/9.2.full.

(Image: Gina Sanders/Shutterstock.com)